Diving into Document Management
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Goal 4: Empower Individuals with Health IT to Improve their Health and the Health Care System

The Vision:

The government wants to arm people with knowledge thereby give them greater control over their own health care. Health IT is a critical tool in both empowering individuals and shifting care to be more patient centered. With the right tools, individuals can become more attuned to healthy behaviors, monitor their health, make informed personal health decisions, and receive preventative care. Patients managing illnesses or other ailments can keep better track of their health care, receive health care solutions remotely, and participate in their care coordination.

The single biggest lever to individual empowerment is access to data. Data liquidity will make health IT meaningful for individuals, promote technological innovation, move care to center more on the individual, and ultimately have a direct effect on population health. Engaging individuals with health data is a top priority of the Medicare and Medicaid EHR Incentive Programs.

Main Purpose (Objectives):

  1. Engage individuals with health IT
  2. Accelerate individual and caregiver access to their electronic health information in a format they can use and reuse
  3. Integrate patient-generated health information and consumer health IT with clinical applications to support patient-centered care

What to Expect:

Engage individuals with health IT

  • Listen to individuals and implement health IT policies and programs to meet their interest
    • The HIT Policy Committee (HITPC) and the HIT Standards Committee (HITSC) – and several sub-committees, or workgroups make recommendations to the National Coordinator on crucial policy and program decisions on an ongoing basis. While individuals and consumer advocates  have been represented on some of the Committees already, the federal government will strengthen that representation
      going forward.
    • Communicate with individuals openly and spread messages through existing communication networks and dialogues. Education and outreach efforts will be aimed at helping people understand the transition to EHRs, the value of health IT and how health IT can be leveraged to make informed choices related to their physical and behavioral health and care.

Accelerate individual and caregiver access to their electronic health information in a format they can use and reuse

  • Through Medicare and Medicaid EHR Incentive Programs, encourage providers to give patients access to their health information in an electronic format.
  • Through federal agencies that deliver or pay for health care, act as a model for sharing information with individuals and make available tools to do so.
  • Establish public policies that foster individual and caregiver access to their health information while protecting privacy and security HHS will support approaches that:
    •  Feature a transparent, understandable, and easy to use online process that enables consumers to download and reuse their data
    • Accommodate the range of user capabilities, languages and access considerations, including effective strategies for ensuring accessibility and usability of electronic health information for people with disabilities and meaningful access to such information for individuals with limited English proficiency.
    • Provide strong privacy and security protections

Integrate patient-generated health information and consumer health IT with clinical applications to support patient-centered care

  • Support the development of standards and tools that make EHR technology capable of interacting with consumer health IT and build these requirements for the use of standards and tools into EHR certification.
  • Solicit and integrate patient-generated health information into EHRs and quality measurements.
    • “Patient-generated insights” are individual’s observations and perceptions about their own health or care. These could come in the form of surveys, health journal entries, online blog entries, or any number of other media.
    • “Device-generated data” is data captured by consumer health IT. Such patient-generated health information can be valuable to providers in adjusting treatment regimens, valuable to individuals in understanding and improving on their health choices, and valuable to the health system in measuring and rewarding for health care quality.
    • Encourage the use of consumer health IT to move toward patient-centered care.

Consumers have expressed interest in the use of health IT tools to make sure their information is correct, look at test results, email providers, schedule appointments online, and refill prescriptions online, all of which lend themselves to more patient-centered care. For care to truly become more patient-centered, providers will need to adopt new processes and uses of health IT that empower individuals in understanding and directing their care.

Goal 3: Inspire Confidence and Trust in Health IT

Main Purpose (Objectives):

  1. Protect confidentiality, integrity, and availability of health information
  2. Inform individuals of their rights and increase transparency regarding the uses of protected health information
  3. Improve safety and effectiveness of health IT

What to Expect:

Protect confidentiality, integrity, and availability of health information

  • • Creation of appropriate and enforceable federal policies to protect the privacy & security of health information.
    • • Impose direct liability on business associates for compliance
    • • Establish new restrictions on the sale of protected health information
    • • Establish new restrictions on disclosing health information for marketing purposes
    • • Specify the conditions under which covered entities must notify individuals, HHS, and the media of security breaches
  • • Enforcement of existing federal privacy and security laws
    • • Establish increasing levels of culpability, increasing penalty amounts
  • • Encouragement of privacy & security to be included into the functionality of health IT
    • • Certified EHRs must:
      • • Encrypt health information
      • • Establish access controls
      • • Generate audit logs
      • • Automatically log off
  • • Identifying security vulnerabilities and developing solutions
    • • Preventing fraud, waste and/or abuse
  • • Identifying & communicating best practices
    • • electronically among states with varying privacy policies
    • • to future health IT workers to ensure compliance with these policies

Inform individuals of their rights and increase transparency regarding the uses of protected health information

  • • Inform individuals about their privacy & security rights and how their information may be used and shared. More information can be found online at the HHS Health Data Privacy and Security Resource Center.
  • • Increase transparency regarding the policy development around sharing protected health information. See more at the official ONC blog, Health IT Buzz
  • • Reporting of security breaches

Improve safety and effectiveness of health IT

Goal 2: Improve Care, Improve Population Health, and Reduce Health Care Costs through the Use of Health IT

The main purpose of this goal is to build the Health IT infrastructure to better:

    • * Anticipate, prevent, and respond to health threats, reportable diseases, and adverse population events
    • * Identify populations with specific health care needs (e.g. at risk populations, children, etc.) and promote their adherence to public health guidelines
    • * Prepare for and respond to emergencies
    • * Communicate with consumers and encourage their participation in public health

What to expect

    • * The widespread adoption and meaningful use of certified EHR technology
    • * Federal health IT investments that  will encourage providers to share information and contribute to improving healthcare coordination
    • * Regional Extension Centers (RECs) to assist providers in evaluating and implementing such tools, and in redesigning their workflows to take advantage of them. These tools will aggregate their practice’s patient population data to perform self-assessments of how they are managing their patients’ health goals.
    • * Increased standardization and automation of health care administrative functions, including the electronic capturing and reporting of health data.
    • * Remote monitoring, tele-health, mobile health applications, and the most advanced means of information exchange

How it will be carried out (Objectives):

A. Support more sophisticated uses of EHRs and other health IT to improve health system performance

    • * Building up the Health IT foundation (changing clinical workflows through EHRs, integrating EHR software, patient registries, and medication reminder systems) supports better decision-making at the point of care and increased adherence to treatment regimens, helping move health care from a reactive system to one that focuses on prevention and improved care management.
    • * The REC program disseminates tools and best practices to providers that need the most help in implementing them into their practices.
    • * Create administrative efficiencies to reduce cost and burden for providers, payers, and government health programs.
    • * Enable a more granular understanding of health care treatments and outcomes, and more complete analyses of treatment costs, ultimately allowing for better disease management and more efficient health care delivery

B. Better manage care, efficiency, and population health through EHR-generated reporting measures

    • * Establish standards, specifications, and certification criteria for collecting and reporting measures through certified EHR technology to enable more cost efficient and timely assessments of health care performance.
    • * Allow providers to assess and monitor their health care performance through ONC open source tools that help providers submit quality measures to government agencies, better understand their patient populations, and identify opportunities for improving the health of their patients.

C. Demonstrate health IT-enabled reform of payment structures, clinical practices, and population health management

    • * Fund and administer demonstration communities to show how the advanced use of health IT can achieve measurable improvements in care, efficiency, and population health. Key findings from these communities will be incorporated into guidance for RECs, State HIE programs, and meaningful use proposed objectives, and thus, will be expanded to a national scale.
    • * Align health IT initiatives and clinical and payment reform pilots and demonstrations. The federal government will monitor and study such efforts around the country and seek to expand on already-successful programs.

D. Support new approaches to the use of health IT in research, public and population health, and national health security

    • * Establish new approaches to and identify ways health IT can support national prevention, health promotion, public health, and national health security.
    • * Increase the performance management capacity of public health departments and ensure that public health goals are being met.
    • * The use of health IT during a public health emergency can facilitate continuity of care for the impacted population by enabling electronic health information to flow for emergency care. In the event of a natural disaster, having health records in an electronic form can help avoid the impact of destroyed paper records and ensure that the affected population’s health information can be accessed in the event of displacement.
    • * Using EHRs may eliminate redundant data entry, thus improving data quality and processing speed; may stimulate a learning health system in which the translation of research findings into clinical care supports continual improvement in knowledge, treatment and health; and may increase opportunities for patients to participate in research, particularly in underserved communities and public health settings. The efficient collection  and exchange of EHR data for research purposes, coupled with the use of applicable EHR interoperability standards in research studies, would also  ensure that key findings that lead to improvements in population and individual health are rapidly translated back into clinical practice.

Too Long, Didn’t Read (TLDR):

EHRs are anticipated to be used nationwide, integrated with other medical software systems, and the data entered and gathered will create efficiencies in administrative jobs, reporting, billing, and even research. There will be demonstration communities where the key findings will be duplicated nationwide. The idea is for us as a nation to be more proactive in managing our health. Also, having electronic data will help with disaster recovery.

Goal 1: Achieve Adoption and Information Exchange through Meaningful Use of Health IT

The main purpose of this goal is to:

  1. Accelerate adoption of EHRs
  2. Facilitate information exchange to support the meaningful use of EHRs
  3. Support health IT adoption and information exchange for public health and populations with unique needs

  What to expect in minority populations:

  • * An increase use of telemedicine, mobile health, or services especially in medically underserved areas.
  • * Practical, effective methods to achieve adoption and meaningful use of health IT within underserved communities will be published annually on the HHS or HITRC website.
  • * Community colleges and universities will offer reduced tuition and grants to qualified health personnel within underserved communities to participate in workforce health IT training programs. Health IT workforce training programs will also be made available to students who attend minority serving institutions, such as Hispanic Serving Institutions, Tribal Colleges and Universities, and Historically Black Colleges and Universities.
  • * Minority and underserved advocacy organizations will understand and communicate to their constituency the general benefits and importance of health IT’s potential to reduce care disparities for underserved populations.
  • * Ongoing education and training programs offered by the National Medical Association , National Hispanic Medical Association, National Council of Asian & Pacific Islander Physicians, and other minority health care provider advocacy organizations.

What to expect in rural areas:

  • * Each state’s HIE Program will identify providers and communities where exchange may not be possible and provide strategic plans for enabling exchange capabilities coordinated with State Medicaid Health Plans to leverage federal resources to specifically meet the needs of underserved communities.
  • * Each state will work closely with the Federal Communications Commission (FCC) to ensure that relevant FCC programs support the Administration’s health IT objectives.

The Big Picture

  • * Information on the overall health of our population will be released from the data collection, tracking, and analysis of stratification of quality measures by race and ethnicity data as mandated in the Affordable Care Act.

This goal will get direct support from the National eHealth Collaborative (NeHC). NeHC will provide logistical, administrative and operational support for the Nationwide Health Information Network Exchange (NwHIN) and will help it evolve from its current form to a scalable, sustainable enterprise. NeHC is also developing in-depth profiles of leading Health Information Exchanges (HIE) to capture success stories on the value, impact, and sustainability of HIE on all stakeholders, including patients, providers and purchasers. The profiles will highlight examples of how organizations use different approaches to connectivity and exchange. The HIE profiles will be widely disseminated to help stakeholders understand how organizations have been successful with HIE, to help build knowledge, and accelerate progress.

Up Next: Goal 2: Improve Care, Improve Population Health, and Reduce Health Care Costs through the Use of Health IT

 

Ever wonder why health care is going through all these IT changes in the first place? Why now? Is the health care system fine just the way it is? And what is the end result expect from implementing all the change? This is something that the Office of the National Coordinator (ONC) has put a lot of thought into and in case you’re not aware, here are the five goals of the Fedral Health IT Strategic Plan for 2011 – 2015.

Goal 1: Achieve Adoption and Information Exchange through Meaningful Use of Health IT
This goal is the centerpiece of the government’s health IT strategy over the next five years.

Goal 2: Improve Care, Improve Population Health, and Reduce Health Care Costs through the Use of Health IT
This goal discusses the specific ways health IT is contributing to the goals of the Affordable Care Act.

Goal 3: Inspire Confidence and Trust in Health IT
This goal focuses on government efforts to update its approach to privacy and security issues related to Health IT.

Goal 4: Empower Individuals with Health IT to Improve their Health and the Health Care System
This goal discusses how the government is empowering individuals with access to their health information.

Goal 5: Achieve Rapid Learning and Technological Advancement
This goal focuses on ways to enable innovation and appropriate use of health information to improve knowledge about health across populations.

We’ll be digging in a little deeper to each of these goals in the coming blog posts. So stay tuned…

With an economy on the fritz and a nation hungry for jobs, it feels counter-intuitive to be making the case for slow growth, particularly in a field that is ripe with opportunity and has major incentives for radical health IT change. A quick solution is what we all need, no doubt.

But both physicians and EHR companies are being rushed. The first group is being rushed to capitalize on government incentives for meaningful use, the second to grab as much market share as possible and drive out the competition.

But is the hyper speed at which we want change to happen the right speed? Is it possible that the rush to EHRs could harm patients? Eric Weaver, wrote an article in the August 2011 issue MGMA Connexion positing this exact theory.

He states, “The federal government is well aware of the disparity between EHR incentives and adequate resources to facilitate the change.”

And, “It would be prudent to delay implementation so the medical practice has time to develop a strategic framework to guide EHR adoption. Successful transition from paper-based charts to EHRs requires an organization-wide commitment, significant process change, and ample human and financial resources.”

And, “It can be unequivocally stated that a poorly implemented EHR can actually do more harm than good, and that many of these failed attempts create a quagmire of wasted capital resources, frustrated physicians and potentially compromised patient care.”

What do you think? Have you had a stellar paper-to-electronic health record experience? Or have you experienced an EHR implementation nightmare? Please, share.

patient charts Many EMR companies boast that they already have a document management component within their system. However, a best-in-class healthcare document management system offers significant advantages over the inherent document management components of EMR systems. In fact, a best-in-class healthcare document management system will process and store both internally and externally created patient records while facilitating secure access for authorized staff in multiple departments and offices, and will present the chart in a coherent, complete way. Many EMRs present patient information in a patchwork fashion.

Additionally healthcare document management systems solve the dilemma of what to do with archived records. EMR systems are typically implemented on a day-forward basis, meaning that years of historical records (potentially 21 years, in the case of infants) remain in paper form. A healthcare document management solution creates the electronic record for both archived and active patient records. In fact, document management smoothes the transition to electronic records by emulating the traditional paper chart file structure, if desired. EMR systems are by definition focused exclusively on patient records. By contrast, healthcare document management solutions provide benefits across the entire organization, creating efficiencies and dramatically streamlining processes in departments like Admissions, Billing, Accounting, Human Resources, Legal, and Facilities Management. Selecting a system with comprehensive security measures and a configurable repository structure allows providers to protect patient records while improving information access for authorized users organization-wide.

Healthcare document management systems cost a fraction of an EMR, and they are implemented in days or weeks, versus months or years. A system properly designed for scalability can be deployed in a workgroup or departmental setting and then easily rolled out to other departments as appropriate.

As a culture, we’ve gotten used to quick turnaround time for accessing things like money, food, or information. We have grown into a self-service mentality where we expect things to be available when we want it – we get upset when we have to wait on someone else.

One way that this shows up in medical practices is that there is only one patient chart and nurses, doctors and/or administrative staff must wait for their colleagues to finish reviewing it before they can get their hands on it. Where we need to be though, is at a point where patient charts are available to multiple users at the same time and where clinicians can view them whether they are at work or at remote locations.

While many EHRs, whether cloud or server based, address the document management piece, it is often dealt with only as an afterthought, making the process of attaching and eventually finding patient information clunky, time-consuming, and an all-around frustrating experience. In some systems attaching the patient’s various documents can take between 5 and 10 steps per document. With the average doctor seeing 4,000 patients and the average patient file consisting of 25 documents, one can empathize with the user feeling like she’s been conned about the whole EHR revolutionizing her job and instead feeling the urge to pull her hair out at the end of the day.

Luckily, we have a solution.

At Aquarius, we use barcode coversheets to convert paper charts to electronic charts in minutes instead of hours. Users can make their electronic charts mirror paper ones, making reviewing patient history as easy as it’s always been, except without the wait. Since electronic charts can be viewed online, securely, by multiple users, easy access to patient history gives clinicians the upper hand in providing better patient care, instead of the headache.

Moreover, TouchChart can be integrated with any EHR. Storing documents and images in TouchChart and making them available via the EHR is great because it doesn’t take the user out of their EHR experience. A physician can look in one place for a patient’s history and physical data and not have to remember if the information was handwritten or entered into the EHR.

It boils down to this: The right data must be available at the right time to deliver the highest quality care. And that’s the real power of scanning directly into TouchChart.


Welcome to our newest forum, Water Blogged, Aquarius Imaging’s official blog where our number one goal is to connect with our community.

At Aquarius Imaging, we understand that the healthcare industry is going through major technological changes and that connection is what matters most. As a country, we are in the process of connecting doctors, patients, hospitals, pharmacies, labs, billing companies, and so much more, all for the sake of creating efficiencies, bettering patient care, and improving the general health of our nation as a whole.

But that doesn’t take away from the fact that there is a mountain full of challenges that need to be overcome between now and “eventually.” Among these challenges are hardware, software, security, reliability, interoperability, accessing patient history, managing change, government incentives, and more.

In short, we get to figure out how to manage a flood of information, from every angle. As document management experts, Aquarius Imaging has a lot of ideas about how to digitize paper, automate workflows, integrate with other systems and ready people for big change — all integral pieces to the health IT revolution.

Going forward, we will be sharing our knowledge on these topics and many more. Please, connect with us.