by
Sean Ruck, Contributing Editor | September 05, 2016
From the September 2016 issue of HealthCare Business News magazine
The University of Pennsylvania has done studies on this. “They have administrative staff that look into things to see if the patient got the recommended follow-up and if not, why not? What they found was that they often did . . . somewhere else,” he said. Another reason found for not following the recommendation, when administrative staff probed, was that there was no good reason for the follow-up. Maybe another doctor received the recommendation, looked and said it wasn’t indicated in the patient.
“So there may be a problem in the adrenal gland, for instance, but they’re already being treated for lung cancer, but we weren’t notified about the cancer. In a case like that, the follow-up wouldn’t be appropriate,” says Hirschorn “It could be because the proper information wasn’t conveyed, we didn’t have access, we didn’t note it, or the contraindication happened in the interim. The EMRs are still at the beginning. They are not an established thing yet.”
Hirschorn says there is still plenty of work to do to make EMRs more effective for this type of tracking. He cites Massachusetts General’s switch last year to a commercially supported system, after using their own homegrown EMR for nearly two decades. It took that long for Mass General to trust that the vendor-provided EMRs could better meet their needs. It’s anecdotal accounts like this that support the notion that vendors and hospitals need to partner more effectively. “If you tell them, in order to go with their product, you need to integrate with all these different things, they’ll assess and give you the price to get it done. Whether it truly plays nice with everything, you may find that out later,” Hirschorn cautions.
If add-on discussions occur post-sale, that’s where costs can rise. “Yes, we’ll let you access your data in another system, but it’ll cost you. That’s where a lot of institutions pushed back. Congress pushed back and regulations have been passed to say information blocking is illegal, that interoperability is not just a lofty goal. It’s required,” he said. According to Hirschorn, some vendors have been slow to come around to that directive and there’s a mix of uninformed employees who still hold the historical company line on information access, and uninformed hospital staff who don’t realize that vendors are required to give them access. “The government has been clear in telling vendors that they can’t put a toll on the road to a facility’s own information,” Hirschorn says.
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