Becker's Hospital Review

44 Health IT I t's old news that hospitals' and health systems' EMR implementation has been a bumpy ride. Physicians struggle with the usability of the systems, and patients report feeling like the computer stands in the way of direct communication, lowering their satisfaction. Regardless, meaningful use incentives are spurring EMR adoption. Even when providers have implemented an EMR, many are not using the system to its full capabilities, suggests a report from Logicalis US, an IT solutions provider. Here are eight mistakes hospitals make in EMRs that prohibit the IT system's optimization. 1. Lack of complete patient records. Hospitals still often store patient data in multiple, separate systems, but interoperability between systems or stor- ing data in one single location would provide a consolidated, comprehensive view of patient data. 2. Lack of patient images. While EMRs store basic patient data, they have yet to easily integrate patient images beyond radiology, suggests Logicalis. Imple- menting a system to congregate patient images in other specialties, such as cardiology and wound care, could help the EMR become more effective. 3. Not following best practices. Clinicians are still untrained on EMR best practices and instead tend to learn as they go or by watching other personnel. Logicalis suggests bringing in a third party to evaluate clinical and financial workflows to enhance clinician use of IT and resources. 4. Not considering disaster recovery. If an EMR fails, health systems can face large overhead issues, including business disruption, lost revenue and patient safety concerns. Providers should have procedures set in place in the event of an EMR outage. 5. Not attesting to meaningful use stage 2. Though meaningful use attesta- tion has been granted "flexibility," providers should still be proactive about meeting the stage 2 requirements. 6. Lack of mobility. Offering physicians the capability to securely access EMRs on personal devices could help integrate the systems into physician workflow. Healthcare organizations need to ensure they have HIPAA-com- pliant and secure measures in place and an up-to-date personal device usage policy to keep sensitive information safe. 7. Not preparing for ICD-10. ICD-10, too, has been delayed another year, but healthcare providers could use the extra time to ensure preparedness. To pre- pare for the transition, Logicalis suggests organizations provide assessments, planning, communication and training for providers to be better prepared when Oct. 1, 2015 rolls around. 8. Lack of analytics. EMRs collect large amounts of data, but the data often sit in storage. Providers need to access this data and analyze it to help improve patient safety, contain costs and improve clinical outcomes. n N inety percent of healthcare leaders re- ported their organizations have begun developing or implementing a tele- medicine program, evidencing an industry-wide embrace of technology to achieve improved qual- ity of care for patients and organizational success. According to the 2014 Telemedicine Survey Ex- ecutive Summary conducted by Foley and Lard- ner LLP, healthcare leaders have reported a strong commitment to adopting telemedicine programs, even in the face of financial barriers and physician resistance. The enthusiasm surrounding telemedicine is large- ly influenced by the shift in financial and payment incentives under the Patient Protection and Afford- able Care Act, according to the report. As providers shift away from traditional fee-for-service reim- bursement models and begin to take on a greater share of the risk — and possible reward — for pro- ducing better patient outcomes, telemedicine of- fers a new solution for streamlining operations and expanding contact with patients. According to the report, while leaders are confident in the potential of telemedicine, the biggest obstacle they are facing in its implementation is getting the physicians who will be using it on board. The report is based on survey responses from 57 healthcare leaders, most of whom are C-level ex- ecutives from for-profit and nonprofit hospitals, home health organizations and physician group practices. The survey was conducted between September and October of this year. Findings from the survey are shown below. • Eighty-four percent of respondents believe the development of telemedicine services is either very important or important to their organiza- tions. Only 3 percent said the technology is un- important. • While only 6 percent of respondents described their telemedicine programs as "mature," just 8 percent said they had none at all. • Thirty-four percent said their telemedicine programs are under construction or in develop- ment, 18 percent said their programs are in the optimization phase and the remaining 36 per- cent are piloting or implementing their programs. • Sixty-four percent of respondents said their telemedicine programs offer remote monitor- ing, 54 percent have store and forward technol- ogy and 52 percent have real-time interaction capabilities. Thirty-nine percent have services that qualify as mHealth — patient-centric apps and online portals. • Fifty percent of respondents ranked improv- ing the quality of care as their No. 1 reason for implementing telemedicine. Eighteen per- cent were most excited for the opportunity to reach new patients. • Healthcare leaders indicated they do not expect an immediate return on investment, despite the cost savings associated with telemedicine. Only 11 percent of respondents ranked the po- tential for increase revenue or profitability as a reason to implement telemedicine. • Forty-one percent of respondents said they are not reimbursed at all for telemedicine services, and 21 percent reported receiving lower rates from managed care companies for telemedicine than for in-person care. • Forty-eight percent of executives said they are more concerned with convincing physicians about the utility and reliability of telemedicine than they are with convincing them that they will be adequately compensated for practicing it (36 percent). • The lack of confidence among physicians in tele- medicine led 87 percent of executives to report they do not believe a majority of their patients will be using any of their organization's telemed- icine services until three years from now. • Almost 25 percent of respondents said they ex- pect fewer than 10 percent of their patients to utilize their telemedicine services. n 8 EMR Mistakes Hospitals Make By Akanksha Jayanthi By the Numbers: How Hospitals, Health Systems are Using Telemedicine By Tamara Rosin

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