EHR integration: Keeping patients at the center of care

There is an enormous range of advantages healthcare organizations can expect from patient-centered EHR integration
By Mark Byers
09:18 AM

As healthcare organizations scramble to meet the progressively more ambitious data exchange thresholds of Meaningful Use (MU), many are focusing on electronic health record (EHR) integration projects for improved flow of clinical data to enable better care coordination across the healthcare continuum.

In the past, projects aimed at optimizing data exchange within EHRs concentrated primarily on improving the transfer of information between providers; little effort was spent making sure that patients were in the loop. While some data sharing exists between providers, patients are all too often left in the dark as to their overall care plans, the cost of treatment and even their own EHR or medical history. As a result of this breakdown in data sharing, most patients tend to receive care passively; with few proactive patients initiating participation in their own care.

All of that stands to change, however, with value-based care on the horizon. Patient engagement and overall patient experience are becoming key parts of the care delivery equation, as focus continues to shift towards better coordinated care efforts. Today, it is generally accepted that patients must play an active role if healthcare is to become more effective and cost efficient. 

Best practices for bringing patients into the loop

Achieving success in the value-based care environment – while improving care coordination – requires a renewed emphasis on ensuring that health information moves just as smoothly for patients as it does among clinical staff. Engaging, educating and informing patients must remain central goals as healthcare organizations invest in major EHR data exchange optimization efforts.

[Learn more: Meet the speakers at the Patient Engagement Summit.] 

A phased method of EHR integration, for instance, allows IT executives to evaluate, analyze and ensure support for improvements at each stage of an EHR rollout. As organizations introduce new or more integrated systems, IT professionals must assess benchmarks relevant to the workflows impacted during these transitions.

It is important for project managers to gather "before" and "after" data snapshots so they can properly evaluate the impact of each phase of EHR integration. Consequently, technical leaders should work with clinicians prior to any rollout to gather metrics around existing key performance indicators (KPIs). As new processes are phased in, further metrics collection can enable data-driven comparisons.

Take, for example, the metrics that might be used to help drive a patient-centered approach to medication administration. Since placing calls to the pharmacy to clarify physician orders is a time intensive task, it directly affects the timeliness of patient care. Therefore, one goal set for the implementation of e-prescribing or computerized physician order entry (CPOE) might be an 85 percent reduction in calls to the pharmacy within 60 days of implementation. Measuring the number of calls to the pharmacy pre- and post-implementation would be one way to measure success.

Similarly, other metrics could align with MU guidelines, such as prescribing antiplatelet medication for Coronary Artery Disease (CAD) patients. Recording and reporting this data through integrated EHRs eliminates the need for labor intensive, manual information gathering.

Aligning patients with EHR integration benefits everyone

In order to best facilitate the care delivery process, patients must be integrated into the fold as EHR integration is a key component in improved care coordination efforts. There are tangible benefits to keeping patients at the center of all EHR integration efforts, including:

·       More patient engagement. When patients "own" their health records, they become active participants in their care, which eases care coordination tasks.

·       Better decisions. Sharing information allows better decision-making for all stakeholders and drives multiple areas of care delivery improvement -- including a more coordinated plan of care and reduction of duplicative tests.

·       A proactive approach. Educated consumers -- who now are shouldering more of their healthcare costs -- can help drive the decisions that lead to more coordinated, proactive and cost-effective health.

In fact, there is an enormous range of clinical and financial advantages healthcare organizations can expect from comprehensive, patient-centered EHR integration.

Another striking -- and cost-effective -- example involves chronic care. Patients with chronic conditions create an intense need for coordination, since safety and quality requirements for these individuals are highly complex. One study indicates people with chronic conditions see an average of four or more physicians a year, with 46 percent taking four or more prescription drugs regularly. This information has drawn the attention of the Centers for Medicare and Medicaid (CMS), which announced plans to pay physicians a monthly fee for monitoring, collaborating and coordinating care for patients with two or more chronic conditions.

Patient engagement yields improved outcomes

Ultimately, to achieve the promise of increased patient engagement and improved care delivery, healthcare IT professionals should ensure that they are aligning EHR integration, technology and clinical goals for the benefit of patients and the providers who serve them. Executive leadership can support these initiatives with top-down messaging that consistently incorporates advanced, patient-centric EHR integration as part of the organization's mission and values. When providers and patients alike are empowered with information, organizations are more likely to see cost decrease and care quality and coordination improve.

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