HealthIT

The increased use of health IT among providers could reduce the number of patients physicians are able to see, according to a study published in the American Journal of Managed Care, FierceHealthIT reports.

Study Details

The study was based on survey responses from primary care physicians in Michigan (Hall, FierceHealthIT, 11/19). The survey -- by the Center for Healthcare Research & Transformation and the University of Michigan Child Health Evaluation and Research Unit -- was conducted between October 2012 and December 2012 and included a total of 739 respondents.

Responses from physicians who were not practicing at the time were not included.

Study Findings

The study found that physicians used a mean of 5.1 health IT services. The most commonly used health IT service was electronic prescribing, while a Web portal for patients to schedule appointments was the least common.

Overall, 83% of respondents said they anticipated having the capacity to accept new patients in the future.

However, the study showed that the odds of physicians who reported having the capacity to accept new patients decreased by 14% with each additional health IT system used.

Further, the study showed that the number of patients seen was more likely to be negatively affected by health IT at smaller physician practices than larger practices (Tipirneni et al., AJMC, 11/17).

According to the study, EHRs and electronic access to admitting hospital records were most closely associated with an expected lower capacity. Meanwhile, technologies that were less likely to negatively affect capacity included:

• Electronic prescribing;
• Reminder systems;
• State immunization registries; and
• Web portals for scheduling appointments or requesting medication refills (FierceHealthIT, 11/19).

The study also found that physicians with higher health IT use were less likely to accept privately insured patients than those with Medicaid or Medicare. The researchers said this was surprising because providers generally receive higher reimbursement rates from private coverage.

The researchers concluded that the findings "call into question" whether health IT expansion "translates into improved efficiency and capacity in primary care practices" (AJMC, 11/17). They added, "In an era of concurrent [health] IT and insurance coverage expansions, policymakers must weigh the unintended consequences of each in order to optimize capacity to care for the newly insured" (Rizzo, "Becker's Health IT & CIO Review," Becker's Hospital Review, 11/18).

Health care systems around the world are being challenged by aging populations, chronic illness and revolutionary -- but expensive -- treatments. Addressing these issues is increasingly dependent on information, as health care is a data-rich, knowledge-driven industry. And yet, the regulations governing health data were developed at a time when the telephone and typewriter were among the most advanced technologies being used in most doctor's offices.

First, let's consider what's at stake. Applying health care data analytics, delivered in a digestible manner when and where it is needed, can lead to faster treatments coming to market, enhanced patient engagement and increased adherence to care plans, as well as reduced fraud -- all of which not only promise to improve the health of our nation's population, but also lower costs for patients and providers by eliminating needless procedures.  

Yet, with medical information doubling every five years, doctors are constrained by the volume of information -- more than 80% of which is unstructured -- which they must work to analyze in order to provide individualized, safe and effective treatment options. Unconnected health datasets provide incomplete pictures of the health statuses and health care practices of U.S. residents, often denying optimal solutions being available to patients in need. 

A more effective approach to health care is to use cutting-edge analytics software to turn data into clinical and business insights that are easily put to use by providers. Effective data analytics can make those insights available in real time for point of care decisions and productivity. Hospitals, medical centers and clinicians can be empowered by seamless, patient-centered, holistic and proactive approaches to drive their interactions with a patient and to deliver better care experiences that emphasize prevention and wellness.

The possible applications of data-driven analytics solutions are virtually endless. These tools can analyze diverse data sources to predict and medically investigate patient safety signals, thereby improving patient safety by identifying potential issues before they become a reality. They can analyze huge volumes of structured and unstructured clinical and operational data for medical institutions to uncover hidden insights. They can even help physicians deliver more accurate diagnosis and treatment decisions for illnesses, increasing practical expertise for a myriad of health care professionals that lack access to advanced knowledge resources. 

But while these IT solutions hold great promise for personalizing treatment and revolutionizing health care, current public policy is standing in the way. There is significant confusion in the market about what technologies may be regulated, by which agencies and to what standards.

Simply stated, America's outdated regulatory approach is harming the development and application of a wide range of data analytic software supporting this revolution, threatening to delay -- or even prevent -- the implementation of 21st century health care solutions. Regulatory uncertainty is holding back the full deployment of countless promising technologies that can help clinicians access more evidence-based medicine, provide patient populations with more individualized care and generate better patient/caregiver/provider engagement.

To address this, HHS recently released a report providing a proposed strategy and draft recommendations to address the problems and shortcomings of this outdated regulatory framework. The FDASIA report makes suggestions to enhance a risk-based regulatory and oversight structure to foster innovation and better ensure the safety and efficacy of a tech-enabled healthcare system. The strategy also correctly espouses a technology-neutral approach, identifying the need to ensure risk and corresponding controls are focused on the actual health IT functionality, rather than on the technology or platform (e.g., mobile, cloud-based, installed) on which such functionality resides.

Most importantly, the strategy promotes the need for three distinct categories of health IT, which should be treated differently based on risk. Those that present a high risk to patient safety must be regulated. Those that present no risk should remain unregulated. And the remainder, those that may pose some risk, should be subject to risk-based oversight that uses consensus standards and private certification bodies to efficiently verify that they function safely and effectively.

With this report, we now have virtually unanimous agreement about the opportunities offered by health IT and data analytics, the steep regulatory barrier to deploying these solutions more broadly, and the need for a new public policy framework that breaks down these barriers. 

The next step is for Congress to act: Leaders in Washington, D.C., must modernize current health IT regulations, which are a product of the 1970s. This new framework needs to be sufficiently flexible to be relevant for current technologies, but also able to accommodate the rapid and hugely promising evolution of health IT.

The good news is that legislation has been introduced in both houses of Congress to accomplish this objective. The bad news is that, like so much in Congress, it remains stalled. On Oct. 7, the Software & Information Industry Association joined with dozens of technology providers, health organizations and trade associations urging Congress to pass legislation to provide much-needed statutory clarity.

Congress should act now to comprehensively reform the regulatory structure for health IT. The longer this is delayed, the longer Americans may be denied the most advanced technologies that can save lives, improve overall outcomes and cut costs.

Health IT executives are unenthusiastic about their organizations' patient portals, according to a study by HIMSS Analytics, Clinical Innovation & Technology reports (Pedulli, Clinical Innovation & Technology, 10/28).

HIMSS Analytics is the research arm of the Healthcare Information and Management Systems Society.

Details of Study

The study is based on responses from 125 health IT executives, as well as information from the HIMSS Analytics database.

Researchers examined providers' experiences with patient engagement criteria under Stage 2 of the meaningful use program (Slabodkin, Health Data Management, 10/29).

Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified EHRs can qualify for Medicaid and Medicare incentive payments.

Findings

The study found that while patient portal adoption is increasing, health IT executives are still unsure of the benefits of such technology (Perna, Healthcare Informatics, 10/28).

That attitude can be attributed in part to cultural issues within organizations that pose challenges to patient engagement initiatives, which is "disconcerting given the fact many hospitals lean on IT leaders to drive the organization's patient engagement efforts," according to the report.

The study also found that:

• 65.8% of hospitals have a patient portal for paying medical bills;
• 23.2% provided patients with access to diagnostic results through the portals; and
• 22.5% allowed access to personal health records through patient portals (Health Data Management, 10/29).

The patient portals often are supplied by the electronic health record vendor that an organization uses, according to the study (Clinical Innovation & Technology, 10/28).

However, while HIMSS Analytics found room for improvement among patient portals, "health care organizations are positively leaning towards implementing patient engagement efforts," according to the study (Health Data Management, 10/29).