Interoperability and EHR use are among the most talked about topics in healthcare

Are interoperability and EHR just buzzwords or are they an integral part of your independent primary care practice? Interoperability and EHRs have been in the news alot lately, but what are they and what do they mean to you? They are actually very important topics that you need to know about, particularly in regards to care coordination. EHR, or electronic health record, enables you to update and maintain your patient’s health information electronically. No more paper forms. No more shuffling through a file trying to find notes from a previous visit. All of your patient’s data is in one place and is easily accessible. Interoperability happens when different EHR systems play well together, enabling you to electronically share information with other providers. Care coordination within an EHR happens with interoperability. When you have a patient who sees a specialty provider, visits a lab for tests, or has medical services provided in another facility, you can coordinate care for that patient with the help of interoperable EHR systems. Interoperability improves the quality of your patient’s care Interoperability can also improve patient safety. Medications can be coordinated. Human error in completing paperwork is virtually eliminated. Waiting for test results to be faxed or called in becomes a thing of the past. These advances are being discussed widely in the healthcare field because they are that important to the practice of an independent primary care physician. As reported in an EHR Intelligence article, “Organizations left and right are recognizing the need for seamless transfer of health data between disparate systems and are working together to do something about it.” EHR and interoperability are becoming particularly important for the independent physician as the healthcare industry moves toward a patient-centered, value-based system. Independent physicians are always focused on the care of their patients and care coordination with an EHR becomes even more seamless through true interoperability. Want to learn more? Contact us today! We can help you maneuver through these terms and show you how they can benefit your practice - and your patients.

David Burke

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What is a health information exchange?

Patient health information often needs to be shared between multiple providers, laboratories, testing sites, and healthcare facilities. When that information is maintained in paper files, the primary care provider must call or fax a request to the other providers or rely on the patient to bring the records to a visit. Sometimes, information from another specialty provider visit is dependent on the patient’s memory. All of these strategies can result in delays, duplications, omissions, and errors. Health information exchanges (HIEs) are more efficient and accurate ways for “health care providers and patients to appropriately access and securely share a patient’s vital medical information electronically,” as stated by the Health Information Technology (IT) office. Data that is transferred via HIEs is typically then incorporated into the patient’s electronic health record (EHR) so the primary care physician has immediate access to critical information regarding that patient. Patient information that is shared using advanced tools such as Collaborative Health Records (CHR) is more dependable and can be transferred in a timelier manner. Elation’s CHR solution enables primary care providers to automatically share updates directly from the Clinical EHR. Other providers get immediately notified so they can take action based on the most up-to-date clinical information. The Health IT office describes three key forms of health information exchange: Directed Exchange – ability to send and receive secure information electronically between care providers to support coordinated care Query-based Exchange – ability for providers to find and/or request information on a patient from other providers, often used for unplanned care Consumer Mediated Exchange – ability for patients to aggregate and control the use of their health information among providers Efficient, accurate information is made available to all providers and healthcare facilities caring for a patient through HIEs. Electronic communication between providers and between the patient and providers can be a useful tool in expediting requests for information as well. HIEs can significantly improve the data a provider has available regarding a patient’s care and, subsequently, improve the level of care that physician is able to provide the patient.

David Burke

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Care coordination v. care management

The terms “care coordination” and “care management” are often used interchangeably. In reality, though, they are considerably different. While both are obviously focused on patient care, there are varying implications in regard to billing, reimbursement, patient management tools, and patient outcomes. Yet the two activities are interconnected. The Agency for Healthcare Research and Quality (AHRQ) describes care coordination as: deliberately organizing patient care activities and sharing information among all of the participants concerned with a patient's care to achieve safer and more effective care. The AHRQ emphasizes that care coordination necessitates communicating the patient’s needs and preferences at “the right time to the right people.” The information must be shared and used in a secure manner and in a way that provides “effective care to the patient.” Further, the AHRQ describes care management as: a promising team-based, patient-centered approach designed to assist patients and their support systems in managing medical conditions more effectively. Care management is a more episodic approach that has, according to AHRQ, “emerged as a leading practice-based strategy for managing the health of populations.” Given the shift toward value-based reimbursement structures, independent physicians are investing in tools that help them more effectively direct their efforts toward the specific and immediate needs of their patients, in a move toward care management. The primary care physician actually has more control over the care management of patients, as care coordination requires the involvement of all stakeholders, including specialty providers and healthcare facilities. The need for care coordination continues to be an important factor in patient outcomes, however. As the population ages and develops chronic or complex conditions, coordinating care between multiple providers will become even more critical to those patients’ well-being. Care management can encompass those care coordination activities. Likewise, care coordination is often included as part of the patient’s care management strategy.

Nick Dealtry

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Who could benefit the most from highly-coordinated care?

Independent primary care physicians know that coordinated care is important for all of their patients. They also realize that some patients have a greater need and benefit more from care coordination in primary care plans. Patients with complex needs and chronic conditions tend to benefit the most from highly-coordinated care, for a number of reasons. Research published by the Agency for Healthcare Research and Quality (AHRQ) describes those with complex health needs as having not only medical issues but quite often social support needs as well. These patients typically are the most costly, primarily due to the wide range and the intensity of the services they require. Patients with complex needs tend to have more emergency room and hospital visits. They receive care in a number of medical facilities, in addition to undergoing a variety of lab tests and other procedures. As such, “they are more vulnerable to fragmented care.” The AHRQ research report points out, though, that primary care providers who “can effectively coordinate the full range of medical, mental health, and social services may have special benefit” for these patients. Patients with chronic conditions also benefit from care coordination in primary care. As the AHRQ research report states, “these patients generally use more health services and receive care from more and different health professionals than do people without chronic conditions.” Coordinated primary care can be the difference for chronically ill patients who see multiple specialty providers. Primary care physicians need accurate and timely information from all providers involved in the patient’s care, to ensure everyone is collaborating effectively. The more efficiently the primary care physician is able to access this information, the more the patient benefits. Highly-coordinated care benefits patients with complex needs and chronic conditions, as well as those patients who are not chronically ill. When independent primary care physicians have the ability to know which providers have cared for their patients, they no longer have to rely on their patients’ memories or to shuffle through paperwork to find that information. The physicians are able to do what they do best and that is to focus on providing the highest quality care to all of their patients. [alexraths] © 123RF.com

Roy Steiner

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Care coordination and value-based care

Now that healthcare has shifted to value-based care and reimbursement, the importance of care coordination has been elevated. How are these two concepts related? Value-based care focuses on the quality of care provided to the patient, rather than on the number of times a patient is seen by a provider. When a patient is seen by multiple providers, such as a primary care physician and one or more specialty providers, that patient’s care must be coordinated between those providers to ensure that the care provided by all is efficient and effective. Lack of proper care coordination can be costly, both in terms of financial expenses and in terms of patient health. Value-based care coordination entails proper communication and sharing of medical information. As an independent primary care physician, you need to know which physicians are caring for your patient as well as which lab tests or medications other physicians have ordered. Otherwise, costly mistakes can be made and the level of care you are able to provide your patient can be diminished. Financially, value-based care coordination can help reduce costs incurred both by the patient and the independent physician. When reimbursement is based on the quality of care rather than the quantity, your emphasis has to be on optimizing each patient visit and ensuring that your patient is knowledgeable, leaving your office with the appropriate treatment plan. Otherwise, time and money can be wasted on unnecessary repeat office visits, lab tests, and even hospital admissions. Surprisingly, while “the move toward value-based care is gaining momentum in the healthcare industry, many health systems are still in the early stages of implementing this model,” according to a recent article in Becker’s Healthcare. The articles also states that the transition to value-based care involves using technology to support informed decisions. Elation’s EHR solution offers you the ability to use that technology to coordinate care seamlessly and efficiently so that you can provide the quality of coordinated care your patients need. Explore a sample chart to see how our cloud-based technology can help you and your patients make the informed decisions that are so important to value-based care.

Aviel Ettin

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ONC seeks input on interoperability progress

For independent physicians, interoperability is a hot button issue, as improved access to a patient’s full longitudinal profile is essential to providing personalized, high quality care.  Physicians seeking an opportunity to get involved in this policy issue can take advantage of a recent request from the Office of the National Coordinator (ONC) for Health Information Technology (IT), regarding feedback on framework they recently created for measuring interoperability standards. Interoperability measurement objectives The Proposed Interoperability Standards Measurement Framework is a move toward standardizing interoperability measurements and establishing consistent standards for the exchange of health data. By engaging with independent physicians and other healthcare providers, the ONC states that it “hopes to develop a measurement framework that is realistic to implement while providing an accurate assessment.” The ONC is “at the forefront of the administration’s health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care.” The ONC has identified two measurement objectives for their framework, which they state will support their ability to measure nationwide interoperability progress. These measurement areas are: Implementation of standards in a health IT product; Use of standards, including customization of the standards, by end users to meet specific interoperability needs. As an independent physician who needs to be able to offer that coordinated care for your patients, you now have the opportunity to give the ONC feedback that may affect your specific practice.  Interoperability enables the electronic sharing of patient information between different EHR systems and healthcare providers. The ease with which different health care facilities can provide coordinated care, interacting with each other to share patient information can significantly impact the quality of care provided to that patient. At Elation Health, we are focused on coordinated care. Our philosophy includes a focus on bridging the chasm, to improve the doctor-patient relationship and to improve the level of interoperability that independent physicians can provide your patients. Contact Elation Health to learn more about our revolutionary, cloud-based EHR system that can help you offer your patients quality, coordinated care as an independent provider.

Dante Capozzola

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ONC chief discusses focus on interoperability

The Office of the National Coordinator (ONC) for Health Information Technology (IT) has emphasized the need to adopt the usage of electronic health records (EHR) for many years. In 2009, the Health Information Technology for Economic and Clinical Health (HITECH) Act charged the ONC with promoting both the adoption and the meaningful use of EHRs. At a recent meeting in Washington, new ONC chief Donald W. Rucker, MD, said that now “adoption is out and usability and interoperability are in as health IT becomes more fully developed and new healthcare laws take full effect,” according to an article in Healthcare IT News. The ONC chief is focused on ensuring that EHRs are usable for the physicians as well as for the patients. Dr. Rucker also emphasized the need for interoperability, ensuring that EHR systems are able to talk to each other seamlessly and securely. In fact, the article states, the “ONC is considering incentives for both providers and patients to share medical records in order to boost interoperability.” True interoperability involves a single patient record that can be shared by all providers, enabling independent primary care physicians to spend less time inputting data and more time with their patients. Elation’s Collaborative Health Record, for example, enables all providers involved in a patient’s care to take action based on that patient’s most up-to-date clinical information. At Elation, we are committed to reducing the independent physician’s burden when it comes to maintaining and sharing patients’ healthcare records. Our EHR solution provides physicians the information they need at the touch of a finger. As adoption numbers increase among independent physicians, the ONC has turned its focus to usability and interoperability. At Elation, our focus has always been on providing physicians the advanced technology they need to ensure they are working together seamlessly for better patient outcomes. [Vasin Leenanuruksa] © 123RF.com

Nick Dealtry

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Why coordinated care is important for independent primary care physicians

Patient safety and quality of care are the highest priorities for any independent physician. Independent primary care physicians understand that patients see specialty physicians, have lab tests and screening tests done, and may even be seen in other healthcare facilities. Coordinated care between all of these medical providers plays a large role for primary care physicians and can be a challenging task. Why is coordinated care important? When providers do not communicate with each other about a patient’s care, it can lead to errors in medication doses or care plans, repetitive tests, and even more serious consequences. Chronically ill patients, in particular, benefit from coordinated care between their providers. A recent study published in the Annals of Family Medicine found that patients under 65 years and patients with chronic conditions were the most likely to experience poor primary care coordination. The study also found that the “rate of poor primary care coordination” was highest in the United States, out of the 11 countries involved in the study. Frustrations of poor care coordination As an independent primary care physician, the task of coordinated care can be a frustrating challenge. You may struggle with receiving timely, accurate information from other providers regarding your patients. Too often, you may have to rely on the patients themselves for that communication piece. Patients are not medical professionals and should not be expected to relay the necessary information between their providers. Given human nature, it is also quite probable that patients will not always remember everything they’ve been told by all of their medical providers, therefore would not be able to share it accurately. Even though your focus is on providing quality care, the lack of coordination can become an issue for your patients’ health as well as for the costs involved in providing that care. At Elation Health, we understand your concerns. We are also focused on quality patient care. That’s why we introduced the Elation Provider Network (EPN), a smarter and more effortless way for providers to connect and share patient information with one another so they can provide better care for their patients. Contact us today to learn more about providing quality coordinated care for your patients.

Roy Steiner

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What is interoperability, and how can independent practices benefit from it?

For independent providers, providing coordinated care can be a huge challenge. When your patients see specialty providers, or have lab tests, or receive services at other healthcare facilities, the primary care provider can be left in the dark. For high quality, coordinated care, this information is essential in making the right decisions to care for patients. So, can independent physicians count on this level of interoperability? It’s become a huge healthcare buzzword. But is it available, easy to do, and making a difference in your patient care? True interoperability would give physicians the ability to actually use the information that is being shared. As an independent physician, you need to be able to interpret data quickly and easily to provide your patients with quality coordinated care. There are some existing ways to provide information - so in some ways, interoperability is already happening every day. Faxes, emails, and even phone calls provide ways to share patient information. However, digital interoperability, where electronic systems are in sync, is more elusive. Taking advantage of digital interoperability Step 1 is using a cloud-based system of updating and maintaining your patient’s health records. This provides the building block of interoperability, putting your notes, the patient’s information, lab results, and other critical clinical data into digital format that can be shared with your patient’s care team. Step 2 is to use a networked EHR.  Elation’s Collaborative Health Record provides connectivity between all of the providers on a patient’s care team, enabling autonomy for each provider over their own version of the patient chart along with the ability to pull in updates from collaborating physicians when applicable. This enables truly coordinated care among all of the providers caring for a patient. In essence, interoperability means that different systems are talking to each other, and that helps to ensure that all providers involved have access and can actually use the information they are sharing. As an independent physician, you need access to information and effective technology to be able to focus on your patient’s care.

Aviel Ettin

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