Meaningful Usage 2 (MU2) core objectives require healthcare practitioners, health centers and care givers to demonstrate meaningful use of Electronic Health Records (EHR) that enable workflow efficiencies, healthcare accessibility and consequently better patient care. This can only be achieved through the effective interoperability of otherwise siloed systems within hospitals as well as laboratories and care givers such as specialized homes and dieticians.
The success of end-to-end mobility solutions as well as modular apps like mobile patient registration apps, e-prescriptions and point of care mobility solutions rides on the seamless flow of information across hospital functions.
While traditional Hospital Information Systems (HIS) take care of the medical, administrative, legal and financial aspect of hospital management, newer systems include EHR systems and support the transition from Patient Health Records (PHRs) to EHRs. This is critical as EHR interoperability across healthcare organizations is a core objective of the MU2 program.
HIS & EHR
Assume that a patient arrives at a hospital with an integrated HIS and EHR system. She walks into the reception and uses a mobile patient registration form that to register herself. Her record is created immediately on the HIS. Based on a short description of her current symptoms, she is sent relevant educational videos and slides on her mobile device while she waits for the doctor. Meanwhile, her details have been sent to the doctor from the front desk.
The doctor views the patient’s details on a mobile dashboard. If the hospital is part of a Health Information Exchange (HIE) network, the doctor can access the patient’s complete EHR in a jiffy. The EHR will give him the patient’s medical history, helping him make an accurate diagnosis, prescribe medicines that are safe, and outline a treatment process. During the patient doctor encounter, the doctor enters his observations into the mobile dashboard in real time. This is automatically updated into the hospital’s PHR or the EHR.
Relevant details are also sent to the pharmacist through an eprescription model, the front desk is sent information for the billing process to be initiated. The front desk also sets a follow up appointment for the patient after checking the doctor’s calendar available via an app. All this would be impossible without backend integration of systems.
Interoperability also helps In-patients by enabling accurate bedside care, post-operative and post-release care. With real time updates to patient records, nurses, lab technicians and other caregivers can perform their delegated tasks on time without manual mistakes.
Integrated systems enable seamless information exchange and mobility creates further operational efficiencies that help hospitals to reduce costs, track and optimize resources, deliver quality care, and promote public health.
Efforts are on to augment the benefits of system integration with EHR interoperability. That is, facilitating patient data exchange between multiple EHRs. There are major technical, infrastructural and political challenges here but some initial steps have been taken such as:
- The development of point-to-point communication protocols for EHRs certified for MU2 to ensure secure transmission of encrypted patient data between providers. The protocol is being developed by the Direct Project, a consortium of EHR vendors, medical organizations, government agencies, and consultants and is expected to become available in 2014.
- The formation of an independent, not-for-profit organization CommonWell Health Alliance that will support universal, trusted access to healthcare data through seamless interoperability on a national level.
Undoubtedly, interoperability is a critical success factor for the achievement of MU2 objectives. Whether we talk about hospital systems or EHR, without interoperability, quality patient care for every American will remain a far off goal.