It’s clear that we’ve entered a time where we’re seeing a great number of pain points in health IT. Some are new; others old, but they’re here and are too obvious to be dismissed. In general, there’s just too much going on in healthcare for many administrators and IT leaders give one single issue much of their focus. A litany of issues exists; from a variety of reform mandates to simple implementation hassles. In fact, there are so many things going on currently that there may be too many to list here, but what follows is an abbreviated list of the top pain points currently pinching health IT leaders.
Transition to ICD-10
As discussed here in the past, ICD-10 and coding changes are huge issues that need to be carefully managed. A benefit long-term, and ultimately a good move forward for healthcare as a whole, the process of moving from 13,000 diagnosis codes to about 68,000 and transitioning from a system that’s about 35 years old is a challenge.
It’s more than that, though. The transition is costly. Moving from ICD-9 to ICD-10 doesn’t mean simply an upgrade, either. Essentially, the two code sets live in separate silos; or on separate planets, you might say. Additionally, the code sets are not necessarily foundational. For example, all of the current ICD-9 codes won’t simply transition to ICD-10 and be built on from there. Some of the codes may live on; some may not. However, the need for change is obvious. Even as new codes are being added to ICD-9, the system can’t keep up with future need. ICD-10 provides the flexibility for this and fixes this these ongoing issues, and the change is for the better.
Meaningful use, with all its benefits – especially in regard to helping create measurable and trackable outcomes across a population and pushing the industry closer to interoperable technology – is creating some struggles for providers in that they’re on the hook for engaging their patients. Reasons for this are obvious: many providers, even with encouragement and instruction, feel patient behavior is something they can’t control or affect. They wonder how they’re going to get a patient in compliance and how they can guarantee that a patient will do the things recommended even though the providers can only offer the tools to encourage better patient/clinician interaction.
Electronic Health Records
Electronic health records are nothing new nor are they groundbreaking at this point, yet they are extremely important and a foundational technology for healthcare. Even with the benefits they create – like most of the pain points listed here – they can be difficult to bring online, are typically expensive and can create more administrative work for providers and administrators. Additionally, implementation of the systems can take a great deal of time and can be difficult to manage without the proper resources. Choosing an appropriate EHR can be a lengthy and time-consuming process. The bigger the health system, the more difficult it is to onboard the systems, not to mention off boarding should there be a reason to change vendors. With each system implementation, records need be to be converted, training provided and processes developed for efficiently managing roles and responsibilities of managing the data contained with the EHR.
As reported by Health IT Outcomes, the Affordable Care Act continues to cause a bit of a challenge, though it’s likely abating given that the program is off the ground and we’re heading into its second year. Of course, that might be the case from the consumer side, the patients that are actually utilizing the care and coverage ACA is granting them. The reason ACA remains somewhat of a concern is that it is fundamentally changing the structure of healthcare — shifting from a fee-for-service to a value-based reimbursement model that rewards optimal patient outcomes – where providers take on more risk when it comes to being compensated for patient care. The problem with ACA is that providers are the ones making the most effort — health IT vendors, pharmaceutical manufacturers and payers are little affected financially, “but the health provider’s reimbursement is under tremendous scrutiny,” the magazine reports. “Providers are under extreme pressure to improve performance and patient outcomes with declining reimbursement, yet they aren’t expected to pay others in the care continuum any less to support them in these efforts.
“Value-based reimbursement will not only hold health providers accountable, it also aims to reduce hospital visits, length of stay and readmissions. This will shift the organizational priorities for many health systems. Health providers throughout the U.S. are trying to figure out what the ‘new normal’ will be when this new reimbursement model becomes the norm. CIOs are at the center of this transformation as they aim to provide the best information technology to support this transition.”
Additional pain points are numerous and include managing data security and effective data exchange; and even managing mobile health initiatives, such as BYOD; HIPAA; and using technologies like tablets and other communication devices.
In the end, there seems to be just too many projects and too few resources to manage the mountain of changes. The sheer volume is overwhelming to manage even though the promise of change will likely benefit healthcare organizations for some time to come. Managing the projects, many at the same time, while managing current protocols is a “balancing act that’s a constant struggle.” Aligning all of these efforts are consuming budgets, not to mention time and staff resources. With this consumption, there’s often little for other initiatives, especially in smaller organizations.
In many cases, collaboration across sectors goes a long way to alleviating some of the stress of these pain points. Prioritization is also key, as is setting measures or establishing guidelines for what will receive the time and money needed. For example, will an initiative better patient care, reduce expenses, increase safety? If the measures are met, those are the projects to receive the green light. Also, according to Health It Outcomes, don’t forget return on investment. “If an initiative has a demonstrable ROI for the health system, then it is will green lighted, even if it doesn’t satisfy meaningful use or other regulatory requirements.”