Major hurdles to Healthcare IT adoption

The Healthcare industry is currently undergoing a metamorphosis which is unprecedented. All the efforts being put in to digitize data is expected to bring in significant changes to the manner in which care is provided. Health Information Technology for Economic and Clinical Health Act was enacted under the American Recovery and Reinvestment Act of 2009, has pushed for the adoption of electronic health records. This has resulted in efforts directed towards innovation in this industry. The intent is to move towards using more evidence-based tools in helping physicians provide better services to their patients. All this is finally expected to result in a smarter healthcare model. However, the entire story looks pretty promising till the issues at hand are considered. The biggest hurdle at this moment, which has the capacity to undermine the entire initiative, is the pace at which the adoption is taking place. The changes in approach which need to be brought in require acceptance and widespread use to ensure that the real benefits are passed on to the patients. Unfortunately there is a lot of inertia amongst physicians against adoption of information technology in their operations. Government is doing its bit by trying to enforce them, through incentives first and planned penalty later, to accept the change. But the real benefits can only be derived if there is a change of heart in the present generation of physicians and the various tools made available at their disposal are used to their fullest extent. The medical schools are doing their bit in making it mandatory for the students to use software tools and devices as part of their curriculum. This will automatically make it possible for them to extend it to their practices because of the familiarity which would have developed. The problem here is that such a phenomena will have a lag time. To ensure that the current population is not denied the benefits or is not made to wait for decade, it is the unwilling bunch of experienced practicing physicians who have to change.

In the current healthcare model the focus is on quantity. Physicians, to run their setups profitably, have to see a large number of patients on a daily basis. They are also badgered by the continual interference of payers who want to call the shots on how patients should be treated. All this has rendered the model effective and unyielding from both the physician as well as the patient perspective. Accountable care Organization is one of the new models which is taking shape as a consequence of these developments. This ties the provider payment to the quality of care and reduction of care cost for an identified population. They are responsible to the patients as well as the payer for the appropriateness, quality and efficiency of care that they provide. They are driven by 3 primary objectives:

• Improved Care
• Improved Health
• Lower per-capita Cost

However, setting up an ACO involves a considerable amount of startup cost and large annual expenses for maintenance. This is where implementation of info systems can be of tremendous benefit – both in terms of reducing the cost as well as improving the quality of care. It is effective IT solutions which can ensure that the physicians receive the best possible information at the right time to enable them to achieve their goals. All this can be done ensuring confidentiality of patient information throughout the processes. But implementation of IT has also had its fair share of challenges which are not completely removed yet. For e.g. an ACO generally has a large number of Primary Care physicians under its wing. each of the setups generally have their home grown EMRs which generally are seen to lack all the functionalities needed to make them comply with Meaningful Use mandates . On handling this issue the next one to surface is generally that of lack of interoperability. As more and more physicians start joining the group ensuring both the above factors is a must. Another issue which came to the forefront was the differing speed of communication at healthcare setups which indirectly affected how fast physicians driven by need could communicate. Clinical software development teams can help you build clinical and EHR/EMR software projects within allocated budgets and time schedules.

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Measures to handle Health IT hazards

Implementation of the Medicare and Medicaid EHR incentive programs has led to widespread adoption of EHRs everywhere. The trigger to all this was with the Obama government encouraging the adoption of Health IT by passing the Recovery Act in 2009. In the year 2011, the Medicare and Medicaid EHR incentive programs made it possible for physicians, hospitals, and other eligible providers to draw incentives for adopting and meaningfully using certified electronic health records. Health IT, besides all the benefits that it is supposed to bring forth, also needs to ensure safety of patients. Understanding the relevance of this area, the federal government has established a communications infrastructure to capture data about IT-related patient safety events. This is expected to hugely benefit the providers since it will result in the right intervention to handle issues when they arise. Thus new systems, when they get implemented, should without fail take into account the safety of patients. Two things hold the key to achieve this; more engagement from the Patient’s end and provision for exchange of patient information among providers. Surveys conducted have indicated some common occurrences of problems which can broadly be categorized to fall under the following heads:

• Information that is very coarse : generic statements
• Information that's too fine : being very specific reduces chances of considering alternatives
• Missing reality : only reports and numbers do not necessarily indicate the actual situation
• Multiplicity : results / analysis from various sources suggesting conflicting information

These are problems which physicians encounter when they deal with Information systems in real time. What needs to be done here is to have a provision for giving feedback to system developers on a regular basis to close the loopholes. Physicians need to be empowered to suggest improvements when they observe problems. Not providing feedback and being operationally efficient in following what the systems prompt can in the long run prove to be a big pitfall for the industry.

Health IT is expected to bring about tremendous benefits to patients care. However since it involves complex technologies, there are high chances of mistakes occurring in its roll out. Information errors comprise a major chunk of the potential hazards of Health IT. From data mismatches to interoperability failures between devices and systems to distractions caused by smartphones and devices, all these have the potential to undo or spoil a lot of the positives of health IT implementation. If we take the last point into account, the event does not seem to be as fatal as the effect it ends up having. In today’s world of BYOD culture, physicians carry their own smartphones and tablets to work. It is quite obvious to have a lot of apps available in these devices in addition to the ones which are required to work with. Since a lot of these apps have live updates etc. it is quite normal to get distracted by them if one were using the device during patient visits with the apps switched on. Apart from the fact that it may lead to mistakes and missing out on relevant information, focusing more on the device might lead to not noticing vital clues in patients affecting the quality of care. The medical schools are trying to address the matted by devising special courses to help the future physicians learn about ways to integrate technology into their workflow without getting distracted or affected in ways which might prove to be detrimental.

Experts in the industry are suggesting ways by which the concern of safety in Health IT can be addressed. One such recommendations is to device a framework which can be rolled out in three phases and get combined with EHR implementation and related Meaningful Use requirements. The important thing to keep in mind is to incorporate safety into training of Healthcare providers and also into certification of software products. The software developers involved in developing these complex systems also need to be involved and explained their need to share responsibility for the safety. Finally measures should be taken to ensure that physicians find it easy and convenient to share their feedback and concerns whenever they want to. Nothing can be more vital than their feedback. Healthcare software development teams can help you build clinical and EHR/EMR software projects within allocated budgets and time schedules.

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