MOST WIRED
Most Wired Hospitals and Health Systems Driving Efficiency, Improvement
Integration of EHRs and population health still underway
July 10, 2017
Rebecca Vesely
Many hospitals and health systems across the country have the technological pieces in place to drive efficiencies and improve both care and the patient experience, but they still have room to further integrate systems and processes and to conduct population health management.
That's the bottom line from the 2017 Health Care's Most Wired survey, conducted by Hospitals & Health Networks and the American Hospital Association with the assistance of several experts from the field.
“I think we see a shift here from, 'How do I get this tech?' to 'How do I deploy this for our strategic objectives?'“ said Chantal Worzala, vice president, health IT and policy operations at the AHA.
Among the bright spots: More than ever before, hospitals are using data and analytics to foster a culture of self-improvement. They are strengthening patients' ability to obtain, use and share their own data and records securely. And they are offering innovative access to care through secure messaging, telehealth and mobile app services. They are also taking cybersecurity seriously with frequent system audits and staff trainings.
However, even those on the Most Wired list have room for improvement on integration. This includes integration of electronic health record systems with population health tools, generating clinical quality measures from the EHRs and incorporating data from outside entities like retail pharmacies.
“While integration tools exist, they are costly and labor intensive and the resulting interfaces are often not highly usable,“ says Neal Ganguly, chief information officer at JFK Medical Center in Edison, N.J., echoing a common sentiment among survey respondents.
Sixty percent of the Most Wired respondents said they have health care-associated infection surveillance integrated with their EHRs, while 40 percent have the data on a departmental system. Sixty-nine percent said they interface EHR data with population health management tools. Only half reported that they can incorporate data from retail pharmacies, and 41 percent said they can incorporate data from governmental agencies.
More Most Wired Profiles and Analysis
Emerson’s Telehealth Program Addresses Pediatric Behavioral Health
A Robust IT Strategy Helps a Critical Access Hospital Remain Independent
CIO Physician Leads Integration at Hackensack Meridian
Carolinas HealthCare Uses Technology to Partner with Patients
ThedaCare Advances Use of Health IT as it Makes 16th Consecutive Appearance
Mercy Health Drives Operational and Cost Improvements with Analytics
Methodist Le Bonheur Relies on its Technology to Support a Patient-centered Culture
Even without seamless integration, hospitals and health systems are advancing their access and use of data to foster a culture of continuous improvement. For instance, 39 percent of Most Wired respondents said their hospital or system delivers applicable quality measures electronically to clinical leaders in real time. That's up from 32 percent in 2016 and 26 percent in 2015.
And 82 percent said they employ tools for retrospective analysis of clinical and administrative data to identify areas for improving quality and reducing costs. More than 70 percent are providing data analytics tool training to physicians and nurses, and three-fourths use sophisticated analytics such as predictive modeling and data to improve decision-making across multiple departments.
“The quality dashboards we’ve built over the last year with our EHR data have led to workflow improvements within our health system; for example, we’ve seen measurable improvements in starting our OR cases on time,“ reports Jon Morris, M.D., chief technology officer and CIO at Wellstar Health System in Marietta, Ga.
We “now have access to data we previously never saw possible,” says Steven J. Hess, CIO at UCHealth in Aurora, Colo. "With our new partners and more on the horizon, we are able to analyze years of historical and case log data to create predictive algorithms. But, we are just getting started in realizing how we can use that health care data and influence the next generation of health care IT and operational intelligence."
Patient access to his or her own information is becoming more available. In 2017, 74 percent of Most Wired respondents said they offer patient-specific education in multiple languages. And 68 percent provide patients with the ability to electronically transmit information about a hospital admission to another care provider. Open notes sharing is becoming more common, with 46 percent reporting the ability to share clinician visit notes with patients.
Harnessing technology to improve access to care providers is also well underway among Most Wired hospitals and health systems. Three-fourths offer secure messaging with providers on a mobile device and secure emailing; 40 percent offer virtual physician visits; and 68 percent allow prescription refill requests by mobile devices. More than half offer telehealth services.
For the first time, the survey included detailed questions on how quickly data could be restored in the event of a disaster that causes the complete loss of the primary data system. More than half of the Most Wired (58 percent) said clinical information systems such as the EHR, laboratory and radiology would be available within four hours, compared with 49 percent of all respondents. Close to half of Most Wired respondents also said that within four hours, they would have access to financial systems, human resources and staffing and supply chain management.
This could be partly attributed to a move to cloud-based computing. Seventy percent of Most Wired respondents said they have backup, cloud-based services for clinical data, a big jump from 49 percent in 2015.
"Safeguarding information boils down to ensuring that three types of data compromises don’t occur: those of confidentiality — is patient data safe; integrity — is it accurate; and availability — is it subject to being held for ransom," says Bob Chaput, CEO of Clearwater Compliance, a sponsor of the Most Wired program.
Indeed, data security continues to take on importance among providers. A full 97 percent of Most Wired respondents use intrusion detection systems; 96 percent perform data access audits; nearly 90 percent run targeted phishing exercises to teach employees and providers to question suspicious emails; and 82 percent engage a third party to conduct annual security audits.
The cybersecurity challenges are “constant and voluminous,“ says Worzala of the AHA. “It's a game of cat and mouse and we are the mice, unfortunately. It is challenging to keep up. I see evidence of real focus in these responses."
Some of these changes are required, explains Sony Jacob, CIO at Presbyterian Healthcare Services in Albuquerque, N.M. “We have invested significantly in cybersecurity and disaster-recovery planning so as to meet some of our insurance plan requirements,“ Jacob wrote in response to the survey.
Keep watching throughout July for Most Wired award announcements, feature articles, and a live Twitter chat during the AHA Leadership Summit, July 28 at 12:30 – 1:30pm Pacific.