Obama’s administration allocated $17B of the recent (Feb 09) stimulus spending package to healthcare, for the purpose of building better healthcare infrastructure. The goal of the new infrastructure is to move patient records online and enable a ubiquitous Electronic Health Record (EHR) to be shared universally among hospital systems. Obama himself promised a total of $50B in spending for this purpose during his campaign. Some experts believe that even more is to come. But, now that some of the money is allocated, how are healthcare institutions getting access to it and what are they doing with it?
Recently, I sat down with the data management team at BridgeHead Software. BridgeHead offers data management software exclusively for hospital systems, leads in protecting Meditech system data, and serves over 1000 hospitals. According to BridgeHead, getting access to the stimulus funding has been a lot of “hurry up and wait” for hospital IT teams. This is despite the advice of HIMSS (the Healthcare Information and Management Systems Society) to healthcare institutions, which says “don’t be a procrastinator” to apply for funding and begin infrastructure enhancements.
Part of the problem is that the criteria for “meaningful use” of the stimulus funds has not yet been defined. Also, most hospitals have some type of EHR system already in place including systems from Siemens, Cerner and McKesson. From a certain perspective, these teams may believe that “there is nothing for me to do.” After all, they already have at least some of their patient data online where they are accessible to support patient care.
One key question, however, is whether those systems encompass everything required in the EHR – including scanned paper documents, email, insurance records, patient histories, prescription records, DICOM images, and more – and most do not. All of that EHR data must also be accessible and shareable with other hospital networks and systems. Putting all of that data online also brings up questions like “who really owns the patient record?”
One outcome of this confusion, as experienced by the BridgeHead team, is that some hospitals are becoming very entrepreneurial. These hospitals have seen the need, and they plan to fill it. They have gone beyond their own institution to establish data systems infrastructures that serve entire regions of hospitals and point-of-care facilities. Known as Regional Centers, these facilities have the potential to grow into Regional Health Information Organizations, or RHIOs (pronounced Ree-Os).
RHIOs are the key building blocks necessary for establishing the nation-wide health network envisioned by Obama and could also provide local physician offices with access to online patient records, eliminating the paper records which have become such a problem to manage and eventually, dispose.
Those at BridgeHead believe that the key to making EHR practical is, in part, making sure that the underlying data management system is designed to support all EHR requirements. This includes managing all of the types of data that make up the EHR, as well as enabling fast search and retrieve of that data from anywhere in the managed repository. Without EHR-aware data management systems, the associated cost of storage can spiral out of control, data records may be unsearchable or searchable only with multi-step, time-consuming processes, and patient records will be next-to-impossible to share across systems.
With EHR-aware data management solutions, however, hospitals have the foundation in place to meet current and future requirements. EHR-awareness includes integration with the applications producing all of the types of data that contribute to the EHR. Applications producing EHR data include digital imaging (DICOM) systems, but also include Microsoft Exchange for email data, SQL Server databases, and scanned document files. EHR-aware data management helps to tie all of these types of data together into a single logical repository, from which the records can be more efficiently searched and more quickly retrieved.
In short, EHR-aware data management provides lower-cost storage retention of the images, faster restore, along with better search and retrieve capabilities. But EHR-awareness is more critical than these benefits. With the coming new world of healthcare patient records going online, EHR-aware data management enables a bridge from old to new world data management. BridgeHead Software is aptly named, providing EHR-aware data management that solves data management challenges for their traditional hospital customers while also preparing those hospitals to offer data services within their regions.
For hospitals that want to take the step of becoming a RHIO, healthcare-savvy data management vendors like BridgeHead Software can be expected to be an essential part of the EHR infrastructure.