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.

EHR Interoperability

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.

Laboratory test results play a critical role in the accurate diagnosis and treatment of patients. In US alone, over 7 billion tests are conducted every day in hospital and clinic laboratories. Despite the massive workloads, medical and diagnostic laboratories have been the most laggard in adopting latest technology. Existing IT systems are unable to meet the growing demand for anytime, anywhere access to patient data. Furthermore, labs are missing out on the performance, efficiency, and revenue gains that enterprise mobility solutions bring to the table.

Every specimen in a lab passes through at least 12 steps from collection to result delivery. Though safeguards are applicable at all stages, manual intervention creates time and risk errors that often lead to wrong treatments, fatalities, litigation, and reputational damage. Mobility solutions can minimize error margins and optimize workflows to help labs produce accurate and timely results, save money, win patient trust, and qualify for incentives under the Meaningful Usage program.

Workflow optimization

Enterprise mobility improves the quality and delivery of laboratory workflows through bedside and point of work solutions. For labs, barcode technology has proved highly efficacious. Mobility solutions enable lab technicians to:

• scan the barcode on patients’ wristband to collect personal details as well as the test to be performed before collecting specimen
• scan their own barcode for identification and accountability
• print barcodes on the spot for accurate labeling of specimen
• access patient information collated from Laboratory Information System (LIS) and Health Information System (HIS)
• send test results to associated physicians, specialists and patients instantly for faster diagnosis and treatment
• match blood tags with patient information on the spot before blood transfusion
• maintain an accurate audit trail for a specimen

Improved patient experience

Point of work laboratory solutions improve the quality of bedside care for patients, ensuring 100% patient safety, accurate treatment, reduced readmission, and patient satisfaction.

Leading labs are also launching mobile solutions to enhance patient experience. Patients are using their smartphones or tablets to:

• search for nearest laboratories
• receive turn-by-turn directions to a lab
• make appointments
• reschedule appointments
• cancel appointments
• receive appointment confirmations and additional information (prerequisites for a test)
• receive notifications of test results, current status, etc.
• view test results

Savings and profitability

Automation and mobile accessibility enhances the productivity of lab workers as they can do more in less time. High accuracy of tests ensures less wastage of lab products. Real time information exchange enables quick recall of drugs and products from inventory as well as hospitals. As every product is bar coded, clinicians can easily detect recalled products, ensuring higher patient safety.

Barcode trace and tracking enables effective inventory management, ensuring labs are never short of life saving products. Lab store managers can reduce product wastage by ensuring products with lower shelf life move to the top of the distribution list.

In sum, mobility solutions help laboratories streamline operations, enhance productivity of workers, reduce wastage, ensure patient safety, improve patient care and boost profitability. Mobile is the way to go.

The healthcare industry is abuzz with strategies and plans to manage initiatives under the new Obamacare guidelines. Enterprise mobile solutions can help healthcare providers manage the transformation and create new opportunities. With the focus moving away from the “pay-for-service” to “pay-for-performance” model, practitioners should leverage technology to enhance hospital processes, support better patient care, reduce readmission, and improve collaboration and communication with doctors, patients, and peers.

One critical campaign that healthcare professionals are juggling with is the unification or integration of electronic health records (EHR). Patient information is currently all over the place, sitting in silos in different patient health record (PHR) systems across various healthcare providers. There is no single consolidated view of a patient’s complete medical history. This works against the effective treatment of patients.

Challenges in EHR Consolidation

How has patient information reached such a chaotic state? When patients consult doctors and specialists affiliated with disparate organizations (a common occurrence) or who work independently, their health record is created on proprietary PHR systems, every time. The records may not be in human readable form and if they are, they don’t really make sense to patients. That’s an eventuality when records are shared. Some hospitals do not even share complete patient information so not even the patient has a complete set of her health records.

The format of health records across PHR systems is not uniform, making integration of data a highly complex and time consuming project. Today, practitioners rely on fax services to exchange patient data with each other despite having access to electronic PHR systems. There is no streamlined conduit for patient information exchange in healthcare that can be accessed by all healthcare stakeholders in a safe and confidential manner.

How enterprise mobility and cloud can help

More than 80% practitioners own a smartphone or tablet that they bring to work. A majority of clinicians access medical applications on their personal mobile devices. Furthermore, the internet has become a common source of information for patients. These facts clearly prove that it is time for healthcare IT to adopt modern technology that will support Meaningful Usage legislation. We’re talking enterprise mobility, network revamping, and cloud solutions; in conformance to HIPAA and HITECH certification.

Access to EHRs on mobile devices will ensure the right information reaches the right people at the right time. Secure cloud implementations will enable anytime, anywhere access to patient information from ubiquitous mobile devices. Of course, hospital networks will require rework to support high bandwidth data. With 3G and 4G data connectivity spreading across continents, that’ the easy part. It’s the interoperability of PHR systems that’s giving healthcare IT nightmares.

Enterprise mobility can help hospitals improve patient care by supporting patient-doctor engagement, real time access to patient information, instant collaboration with peers, and disseminating healthcare monitors that patients can take home. The goal of Obamacare is admirable but tough. Technology can make the transition work to your advantage.