IT key to successful e-health record rollout

Health care pros first need to understand the technology they already have

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Getting certified

The nonprofit Certification Commission for Health Information Technology (CCHIT) is currently the only organization accredited by the U.S. Department of Health and Human Services (HHS) to certify that EHR systems in use at private physician practices and larger healthcare facilities meet meaningful use criteria. The HHS's Office of the National Coordinator is currently working on new rules for accrediting other organizations to certify EHR systems.

"Until that happens, there can be no final certification of products that physicians and hospitals can rely on," said Sue Reber, marketing director at the CCHIT. "So it looks like it's being pushed pretty far back, and that creates a problem. If you're a physician and you've already rolled out EHR under a previously accredited vendor... then all you have to do is get the product updated with the vendor's newly accredited software [and if you] have fair amount of patient data to work with, you'll be in pretty good shape."

For hospitals, EHR certification is even more complicated. That's because hospitals don't rely on all-inclusive bundled systems like the ones that smaller practices purchase. At hospitals, technology is rolled out piecemeal and requires integration. Since many hospitals won't consider ripping and replacing existing IT infrastructures, they're forced to integrate new documentation systems, CPOE systems and relational databases with existing technology.

Most hospitals began using health information technology far earlier than smaller physician practices, but they purchased that technology department by department. A hospital, for instance, may have a patient admission system for its front office; a different patient transfer system for other departments; separate administration systems for the emergency room, the laboratory, the pharmacy and the radiology departments; and separate physician order entry systems. And all those systems may have come from different vendors.

The CCHIT, which has been certifying health IT systems since winning a federal government contract in 2006, is currently developing a program to be launched this summer called "Site Certification." The program and accompanying services allow inspectors to check a hospital's systems over the Web in order to certify them for meaningful use.

Until then, according to Reber, the most definitive source for information on "Meaningful Use" rules can be found on the HHS's health IT Web site.

The EHR payback

Denver Health, a health care group that serves some of Denver's poorest, uninsured residents, has recovered more than $28 million in revenue over a five-year period by digitizing its manual patient-tracking and claim-submission systems.

Gregg Veltri, CIO at Denver Health, said the ROI goes far beyond the money. For example, in his organization's pharmacy, a physician order used to take almost an hour and a half to process using a paper-based system. Once the EHR system was in place, that time dropped to 7.3 minutes.

"If you're on an antibiotic for a raging infection, the difference between 84 minutes and 7.3 minutes is a big difference. Or if you're in pain, 84 minutes is a long time," he said.

The CPOE system also cut down on mistakes. "It's legible," said Veltri, who used EMC Corp.'s consulting business to help with the rollout. "There is no, 'Is it penicillin or ampicillin?' As we all know, doctors' handwriting is interesting."

Far from being disheartened, most health care IT pros are looking forward to the progress they'll be able to make on patient care through the use of more highly integrated systems. "It's nice walking up to a unit and seeing a nurse or physician use the system and seeing it change the way we care for a patient," Podesta said. "To me it's very satisfying, as opposed to being a CIO in the banking or insurance industry. I can't impact the quality of someone's life in the same way there.

"In health care, it's a great time to be a CIO, even though there are lots of challenges," he said. "You need to embrace it and know you're making a difference and leaving a legacy behind."

Lucas Mearian covers storage, disaster recovery and business continuity, financial services infrastructure and health care IT for Computerworld. Follow Lucas on Twitter at @lucasmearian or subscribe to Lucas's RSS feed . His e-mail address is lmearian@computerworld.com.

Copyright © 2010 IDG Communications, Inc.

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