Adoption of Electronic Healthcare Records

Alexander FloresArin Halicki

Tiangan LianDamien Mar Chong

Mahesh Seethraman

Introduction

State of US HealthcareRising CostsQuality of CareRecent Legislation

Solution: What can EHR do for you?

Network Good EHR is a Network good with it’s own delicate eco-system….

Hospitals Doctors

Benefits

Patients

Insurance Companies

Government

Benefits

Medical Groups

EHR(platform)

EHR Platforms

Interoperability and Scalability Can Drive EHR Success

Different versions Formats Language Service offerings

Different pricing models Size Bundles Incentives

Products Scalability / Cost Language/ Interoperability

EPIC Systems Corporation •Ambulatory & Inpatient•Specialties / Departments / Ancillaries•Health Information Management (HIM)

Medical Groups to Practices or Organizations of any Size

•Health Level Seven (HL7 )•ANSI X12•XML

Allscripts-Misys Healthcare Solutions, Inc.

•Practice Mgmt Systems•Electronic Prescribing•Document Imaging•Patient Access

Individual Practices to Practices or Organizations of any size

•CCHIT Certified•Open Source Connect written in Java

Cerner Corporation •Hospitals /Health Systems•Private Practice •Pharmacy•Employers•Home Care•Services & Devices

Individual Practices to Practices or Organizations of any size

•The Digital Imaging and Communications in Medicine (DICOM)

GE Healthcare •Hospitals /Health Systems•Private Practice •Pharmacy•Peer Vision•Processing & Planning•Services & Devices

Medical Groups to Practices or Organizations of any Size

•The Digital Imaging and Communications in Medicine (DICOM)•Health Level Seven (HL7 )•Integrating the Healthcare Enterprise (IHE™)

What’s driving EHR adoption?

What’s driving EHR adoption? American Recovery and Reinvestment Act of 2009

2011 – 2015 scaled payment incentives to hospitals and physicians By 2015 scaled reimbursement penalties from Medicare plus

escalation

Reporting treatment outcomes and other metrics Physician Quality Reporting Incentives (PQRI) State Reporting Requirements eg. CA DMHC/OPA/OSHPD Pay for performance

Improved Quality – error reductions

Cost reduction

Top Motivating Factors for EHR Adoption (75% of Hospitals)

Share patient-record info among healthcare practitioners and professionals

Improve clinical processes or workflow efficiency

Reduce medical errors; improve patient safety

Improve quality of care

State and Pattern of HIT Adoption, RAND, 2005

Factors Influencing EHR Adoption System-level factors

Regional factors

Hospital type

Hospital-bed-size

Medicare and Medicaid

Physician practice and size

By System-Level Factors

By Regional Factors

By Hospital Type

By Hospital-Bed-Size Category

By Medicare

By Medicaid

By Practice and Size

Barriers to EHR Adoption

Older Records Costs of conversion Ownership Other challenges (Tech/Human)

Patient rights & Privacy HIPAA regulations Digital security Theft of information

Barriers to EHR Adoption

Other reasonsLack of support from medical staff

Resistance to change

One system does not fit all needs Fragmentation & customization

ROI impact

State and Pattern of HIT Adoption, RAND, 2005

Barriers to EHR Adoption

Interoperability Synchronization Hardware

Costs Who pays for it Startup costs Maintenance costs Hardware – High fixed costs Process change

Recommendations Single payer system

Create interoperability standard

Public-private ownership for patient information

Financial incentives for EHR Adoption Leasing of EHR solutions or SaaS

Pay for performance

Free/Subsidized basic System

Train new healthcare practioners about EHR. At Medical schools