Perhaps the best way to spur enthusiastic and rapid adoption of the often mandatory healthcare technologies soon to arrive in clinics and hospitals is to demonstrate the successes that early adopters are enjoying.
That was one thought behind the Health Information Technology (HIT) Day organized recently in Annapolis, Md., by the Maryland chapter of the Health Information Management Systems Society. In his opening keynote, Dr. Peter Basch of MedStar Health -- an early adopter and HIT evangelist -- shared his personal experiences and explained how technology has streamlined workflow, fostered patient engagement, and allowed for more comprehensive "shared agenda" patient visits. Though patients may come in for one issue, he said, these visits encompass any and all topics, such as overdue checkups and other health conditions.
Patients are engaged through a patient portal and can see lab results much faster than the traditional means of phone, mail, or fax. Telemedicine costs far less than face-to-face interactions. Technology allows patients to be sent home sooner, improving the quality of care while reducing costs.
Basch highlighted the MedStar Million Hearts campaign, which encourages patients to set achievable health goals to be monitored through technology. Of 68,000 patients seen in a four-month period through this program, 96 percent established blood pressure and cholesterol goals, he said.
Each day, Dr. Barton Leonard of Johns Hopkins Medicine uses the Chesapeake Regional Information System for our Patients, Maryland's health information exchange, which is now entering its fourth year. Connected to all hospitals in Maryland, CRISP provides patient records from previous hospitalizations, along with lab and radiology tests and medication history. Authorized professionals access it about 10,000 times a month.
Leonard lauded CRISP for delivering on something that had been discussed for 30 years. He told the story of a young patient who had a life-threatening infection. Time was of the essence, so the first medication had to work. Because CRISP housed the patient's complete record, Leonard could quickly choose the most appropriate and effective antibiotic, which saved the patient. As an additional service, CRISP sends 8,500 real-time alerts per month to physicians and care coordinators when patients under their care are hospitalized.
Tools of the Trade
Computers are becoming as ubiquitous as scalpels and tongue depressors as more physicians
use them to treat the whole patient.
Patient care increasingly is interdisciplinary and collaborative, according to Dr. Andy Barbash of Holy Cross Hospital in Silver Spring. Doctors can engage family members who may be far away -- even on a different continent.
Technology often isn't expensive. Barbash recalled one patient who was expecting triplets; unless she got specialized care quickly, she was in danger of losing two of her babies. The physician used technology to consult with two other doctors and the patient's husband, each in a different city. The best-suited specialist was located via an online search, an appointment was arranged, and the patient was seen -- all in time to ensure the delivery of three healthy babies.
Dr. Neal Reynolds of the University of Maryland Medical System said technology has compressed time and distance and brought doctors and patients closer. In the past, when ambulance crews brought patients to intensive care, they had no idea of the wait time at a particular hospital. Now they are aware of caseloads at the primary location and can be diverted to feeder hospitals, where patients can be treated sooner.
Healthcare legislation at the state level goes hand in hand with the success of HIT. Telemedicine legislation in Maryland allows doctors to get paid for virtual visits. However, it does not address Medicaid reimbursement. Even though 16 states and the District of Columbia have telemedicine bills or laws, additional legislation is needed to allow doctors treating a patient collaboratively across state lines to be paid.
We also need laws that balance the benefits of data sharing and the need to protect privacy to deliver on the promise of improving quality and affordability of healthcare. On the technology side, the public demands improvements such as the ability to choose what portions of a health record can be shared and with whom. Today it is opt in or opt out for the entire patient history.
It's not perfect yet, but it was really exciting to see how HIT is improving the quality and affordability of healthcare already.
— Mansur Hasib has served in CIO/CISO and other leadership roles in the public, private, and education sectors.