BEYOND THE EHR MEANINGFUL USE, CONTENT MANAGEMENT AND BUSINESS INTELLIGENCE

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1 WHITE PAPER BEYOND THE EHR MEANINGFUL USE, CONTENT MANAGEMENT AND BUSINESS INTELLIGENCE By Richard Nelli, Senior Vice President and Chief Technical Officer, Streamline Health

2 PAGE 2 EXECUTIVE SUMMARY When The American Recovery and Reinvestment Act (ARRA) was passed in February 2009, it offered monetary incentives for providers to adopt electronic health record (EHR) systems. Many providers sought out that one EHR solution that could help them satisfy meaningful use criteria and receive incentive payments. Meeting Stage 1 requirements is challenging, but Stage 2 is even tougher, with increased thresholds and demands for health information exchange that are pushing hospitals to upgrade or even overhaul their technologies and workflows. The objectives require better automation and proactive information management. Caregivers, for example, must be able to transmit prescriptions electronically, send reminders and provide patients with an electronic copy of their health records. In order to meet those goals, healthcare organizations of all sizes require additional technologies to enhance core clinical systems. In light of these changes, most providers have come to realize, there is no single EHR that will enable them to achieve meaningful use. Implementing an enterprise content management (ECM) system can close the divide. ECM supports meaningful use by connecting content that lies outside the EHR and bringing it securely and efficiently to a single place, enabling users to make the right decisions, at the right time. ENHANCING THE POWER OF THE EHR In order to easily and efficiently share patient information across departments and healthcare settings as required by Stage 2 of meaningful use providers will need to capture, manage and make electronically accessible a broader set of clinical data elements. The ability to do so, however, is complicated by the fact that much of a patient s health information is contained in unstructured narrative documents. Despite recent advances, many organizations still operate in a hybrid environment of paper documents and electronic records. Even highly digitized hospitals have historical data stored in paper format. Content falls into one of two categories: structured (data in fields and columns, such as a patient s social security number or date of birth) or unstructured (paper, forms, referrals, reports, faxes, videos and medical images). Industry experts estimate that as much as 80 percent of an organization s data is unstructured.1 This type of content is a rich source of information for care delivery, decision support and research, and it is also an important part of creating a full EHR. By their very nature, these unstructured documents cannot reside in an EHR system s discrete fields. In the current document-management process, a scanned image of a document is attached to a patient s electronic record. With no contextual data about the attachments, healthcare providers cannot automatically search the EHR database for information within the document. This inability not only impedes meeting meaningful use criteria, but also creates a gap in the patient s clinical narrative, which could adversely impact the quality and cost of care. With unstructured information constantly streaming in, healthcare organizations require a method to capture and process external content and make it part of the EHR. One way to resolve this issue is to implement ECM technology that will enable providers to securely integrate documents and data into their clinical and business processes, relieving workload demands and saving valuable time. ECM technology supports Stage 1 Meaningful Use requirements for data capture and sharing. It can help EHRs by filling the gaps and placing that content in the right context for the right end user. ECM can also help ease the transition from clinical workflow dependent upon paper charts to an all-digital approach, thereby facilitating EHR adoption.

3 PAGE 3 IMPROVING HEALTH INFORMATION MANAGEMENT PROCESSES Stages 1 and 2 of the meaningful use program have set the stage for electronic exchange of protected health information (PHI) between providers, patients and payers.2 Some of the core objectives outlined in Stage 1 require healthcare organizations to produce patient information electronically upon request and offer electronic discharge instructions to patients. Stage 2 ups the ante, with core objectives that require eligible providers to: Allow patients to view, download and transmit their medical information online3; Send summary of care documentation for follow-up providers through secure, directed exchange-based messaging4; and Incorporate lab results as structured data within the EHR5. The ability to share documents across the system is fundamental to health information exchange (HIE) and meaningful use, but it has also created challenges for health information management. Faxing and other paper-based technology compromises security and quality control and leads to audit trail deficiencies. ECM can provide the flexibility and ease of reporting needed for compliance and accounting of disclosures (AODs). With enterprise-wide access to documentbased patient medical and financial records, an integrated document management solution accelerates the completion of tasks and streamlines processes for better and faster health information management, featuring: HIPAA-compliant security with multiple tiers of protection from a process level down to specific fields; An administrator-friendly set-up that makes changes quickly, easily and in real-time; Instantaneous and online auditing that records the flow of work at the Medical Record Number (MRN), encounter or visit level, making research and client service queries a one-click event; and Detailed logging and tracking of any information accessed and/or action taken regarding PHI. Document management systems digitize requests for patient information, thereby streamlining workflows, reducing costs and enabling the secure transmission of PHI. Through data sharing and system interoperability, ECM supports meaningful use, improves records management, supports HIPAA and Joint Commission compliance, and provides improved accessibility through physician and patient portals. LEVERAGING BUSINESS INTELLIGENCE It is critical that providers not only understand the structured and unstructured data that flows through their systems, but that they have the ability to organize and analyze all of the data that s collected so they will be prepared for the future and the next set of challenges they will be faced with. By funneling this information into a business intelligence solution and analyzing and reporting on the data, healthcare providers will have the ability to combine clinical, financial and administrative information to create actionable solutions to important challenges. Integrating ECM with business intelligence initiatives can help healthcare professionals meet meaningful use requirements through the proactive tracking of measures for process improvement. A business analytics solution enables providers to make informed decisions by giving them real-time, on-demand access to information that can be easily viewed, analyzed, and shared across the enterprise. By pairing a real-time data analytics and reporting engine with robust workflows and Web-based access, hospitals and physician groups will have a new level of insight and transparency to drive cash flow, reduce accounts receivable, improve net revenue, and heighten levels of patient and employee satisfaction.

4 PAGE 4 Business analytics solutions using Web-based access can provide a true return on investment by: Aggregating data from disparate systems, simplifying access to financial and clinical information with a web-based solution; Building successful processes around areas of opportunity and conducting in-depth root cause analyses; Instantly prioritizing the entire accounts receivable management and liquidation process in order to minimize the cost to collect and maximize overall cash collections; Addressing enterprise-wide cash flow risks arising from both governmental and private payer audits; Automating the entire overturn process for maximum net revenue improvement; and Tracking key performance indicators (KPIs) across multiple clinical, financial, and administrative departments. CONCLUSION Meaningful use is not only about receiving stimulus payments in exchange for using an EHR, but setting the stage and changing behavior for value-based purchasing and healthcare reform. Meaningful use is about driving fundamental change in the form of patient-centric accountable care with clinical integration and care coordination. This change will be facilitated by using population health, disease management, and care collaboration solutions, health information exchanges (HIE), and, just as importantly, key business intelligence. Today s healthcare organizations must be adaptable in this environment of rapid change, heavy regulations and continual reform. Ultimately, healthcare providers must overcome these operational challenges with flexible and effective strategic solutions to be successful and achieve ongoing financial viability. The plethora of governmental regulations that are facing healthcare providers are easier to manage with the right technology. By utilizing solutions like ECM and business analytics in conjunction with an EHR system, healthcare organizations are able to aggregate, organize and integrate complex data sets from multiple, disparate systems. When all of the data is easily accessible in one place, providers are empowered to make faster, more informed decisions so they can meet the challenges of an ever-changing healthcare industry today and prepare for the challenges that lie ahead.

5 PAGE 5 REFERENCES 1 White, Colin. Consolidating, Accessing and Analyzing Data. Dec. 12, U.S. Department of Health and Human Services press release. Aug. 23, MeaningfulUseSpecSheet_TableContents_EligibleHospitals_CAHs.pdf. Objective 6. 4 MeaningfulUseSpecSheet_TableContents_EligibleHospitals_CAHs.pdf. Objective MeaningfulUseSpecSheet_TableContents_EligibleHospitals_CAHs.pdf. Objective 8.

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