Pennsylvania Hospitals’ Adoption of Health IT: Keeping our Promise to Patients
As we close in on the final weeks of 2015, I am reminded of an important promise made to Pennsylvanians when our nation’s first hospital was founded in Philadelphia in 1751—a promise to care for the sick.
Since the days of colonial America, technological advancements have changed virtually everything about the way that health care is delivered. Some 260 years later, Pennsylvania hospitals and health systems continue to harness the power of health information technology (IT) in an effort to keep that promise to patients.
Earlier this year, the Office of the National Coordinator for Health Information Technology (ONC) released its report on electronic health record adoption and found that nearly all hospitals in the United States have electronic health record technology that meets federal requirements.
HAP recently analyzed the ONC findings from Pennsylvania, and found that 97 percent of hospitals reported having electronic health record technology that meets federal requirements as well. Our Pennsylvania Progress in Health Information Technology report demonstrates Pennsylvania hospitals’ and health systems’ rapid rise and adoption of health IT. This has been critical to maintaining our promise to patients while we transition to a system focused on outcomes, population health management, and patient-centered and coordinated care.
HAP’s report finds that hospitals and health systems across the state are actively engaged in building health IT infrastructures and view information exchange as vital. Hospitals’ and health systems’ electronic health record capabilities include the following:
- View report and image results (80–99%)
- Conduct provider order entry (94–99%)
- Exchange data with system (72–98%) and non-system hospitals (48–73%) and system (56–91%) and non-system ambulatory care providers (62–90%)
- Conduct clinical documentation (93–100%)
- Notify primary care providers when patients visit emergency departments (63%)
HAP’s findings also demonstrate Pennsylvania hospitals’ and health systems’ commitment to the implementation of health IT across a broad range of functions, including:
- Telehealth (77%), mobile devices (88%), and barcoding (65%)
- Decision support (85–96%)
- Population health management (95–97%), care summaries (85–96%), and medication management (73–99%)
- Automated quality (59–84%) and public health reporting (83–95%)
Hospitals and health systems also are making changes in health IT that allow them to use data to measure and deliver quality, as well as engage patients and families. Consider, in Pennsylvania:
- Eighty four percent of hospitals reported being able to automatically generate quality measures from an electronic health record and nearly 90 percent are able to submit surveillance data to public health agencies.
- Nearly 100 percent of hospitals can support population health management with electronic health IT systems that provide patient-specific education resources and generate lists of patients by condition.
- Nearly 95 percent of hospitals have electronic health IT systems that allow patients to view online health/medical records, and nearly 85 percent have systems that allow patients to download that information.
In north central Pennsylvania, Geisinger Health System’s data warehouse, which was built during the last decade, is now able to deliver providers real-time patient alerts for inpatient critical care areas.
In southeastern Pennsylvania, Penn Medicine has made major investments to develop its electronic health record infrastructure to capture patient data and incorporate it into a clinical data warehouse. The data is being used to develop algorithms that can predict adverse events before they happen.
Similar in concept to the algorithms used by Amazon and other retailers that suggest additional items based on your viewing history, Penn Medicine is honing care teams’ ability to predict the onset of severe sepsis. Using conventional tests and examinations, doctors typically can detect about 45 percent of patients who are likely to develop severe sepsis. When Penn Medicine’s “PennSignals” was deployed this summer, care teams were able to predict 80 percent of the patients at high risk for sepsis, and much sooner than conventional methods.
“We’re taking the best that humans have to offer and best that computers have to offer and combining them,” says C. William Hanson, MD, Penn Medicine’s chief medical information officer. Now, Penn Medicine is expanding this approach by deploying algorithms to predict heart failure and complications associated with childbirth.
We are making tremendous progress through these innovations. At the same time, there are challenges. HAP’s report also finds evidence that many Pennsylvania hospitals and health systems are still experiencing constraints with health IT systems, such as not being able to efficiently share data. While nearly 80 percent of hospitals, on average, reported being able to exchange data within their own systems, 65 percent reported that they routinely do not have access to necessary clinical information electronically from outside their systems.
The complexity of health IT systems, constantly changing certification and meaningful use requirements, vendor delays, and implementation issues are forcing many hospitals to make major system changes very quickly. The number of hospitals reporting that they are changing vendors or adding significant additional functionalities during the next 18 months more than doubled from the year before, to 71 percent. Only nine percent of hospitals said they had no major changes planned.
Earlier this year, Lehigh Valley Health Network and St. Luke’s University Health Network began the process of migrating to a new electronic medical record system.
At Lehigh Valley, the system will replace dozens of separate computer systems, allowing the exchange of patient information as well as reducing unnecessary paperwork, duplicate testing, time delays, and medical errors.
At St. Luke’s, the new system—which will go live during January—was selected because its current system would be out of compliance with 2018 regulations. It will allow better coordination of all aspects of patient care. St. Luke’s also has plans for the system to allow patients to more fully engage in their care.
Changes to improve IT efficiency and changes to federal technology requirements can be resource intensive. Lehigh Valley is spending $200 million on its system. St. Luke’s had to hire more than 100 additional employees. Chad Brisendine, St. Luke’s chief information officer, calls it “the single biggest technical investment” in the network’s history.
To support hospitals and health systems in their continued commitment to the promise of care made long ago, and to address the challenges and obstacles to keeping that promise, HAP will continue to advocate with state and federal lawmakers and regulators to ensure a thoughtful and reasonable approach to health IT.
At the same time, we will continue to advance legislative and regulatory strategies that enable hospitals and health systems to forge better connections with other providers across the continuum of care and engage patients.
We stand on the cusp of truly advancing value in health care. Having a robust exchange of health information, the ability to use information to better predict care needs, and engaging patients in managing their health are what hospitals and health systems are striving to do. HAP is here to make sure the funding and regulatory environment is in place to support you.
About the author:
Andy Carter, President and CEO
The Hospital & Healthsystem Association of Pennsylvania