Healthcare Data Interoperability: What s Required to Establish Meaningful Use

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1 WHITEPAPER Healthcare Data Interoperability: What s Required to Establish Meaningful Use Driving Healthcare Efficiency As the cost of healthcare increases, so does the drive of healthcare organizations to reduce their costs without sacrificing patient care. The first steps that hospitals, clinics and other healthcare providers take to control costs are improving operational efficiency by automating processes, speeding the delivery of information and ensuring that patient records are distributed securely between hospitals, physicians, pharmacies and other parties involved in patient care. Also important in optimizing efficiency is ensuring the ability to access critical patient information and maintain continued operations and uninterrupted patient care during a system failure or downtime. In the drive to control costs, healthcare organizations have had to address certain challenges, specifically compliance with government regulations such as HIPAA and industry requirements such as the HL7 standards for the exchange, integration, sharing and retrieval of electronic health information. To ensure the security and privacy of patient health data as well as improve the efficiency and effectiveness of the delivery of health care, HIPAA s provisions promote the widespread use of electronic data interchange in the U.S. health care system. The HL7 data interoperability standards are also firmly based on increasing the efficiency and effectiveness of healthcare delivery, setting guidelines for processing and sharing information in a consistent and uniform manner. What we have learned, as the nation debates our current healthcare system and providers struggle with elevating the level of patient care while keeping down costs, is that an improvement in the state of healthcare will ultimately be driven by information technology. IT is viewed as the most promising tool for improving overall quality, safety and efficiency of the healthcare system. The HL7 data interoperability standards are also firmly based on increasing the efficiency and effectiveness of healthcare delivery, setting guidelines for processing and sharing information in a consistent and uniform manner

2 Opportunity for Healthcare Providers To improve the healthcare information infrastructure as well as stimulate the economy through new investment and job growth, the American Recovery and Reinvestment Act of 2009 (ARRA), signed by President Obama on February 17, 2009, includes legislation providing billions of dollars in stimulus funding for healthcare IT. Under the health IT stimulus law, healthcare providers who demonstrate meaningful use of electronic health records (EHRs) through the implementation of certified EHR technology, beginning in 2011 and by 2015, will qualify for Medicare and Medicaid incentive payments. Those providers who do not have certified technology by 2015 will receive disincentives in the form of reductions in Medicare payments. According to HIMSS (Health Information and Management System Society) and its Summary of ARRA Key Health Information Technology Provisions, certified EHR technology must include patient demographic and clinical health information, such as medical history and problem lists, and has the capacity to provide clinical decision support to support physician order entry, to capture and query information relevant to healthcare quality, and to exchange electronic health information with, and integrate such information from other sources. 1 What is meant By Meaningful Use? As of the publication of this white paper, the term meaningful use has not received an exact definition. According to a definition provided by HIMSS, to be a meaningful user, an organization must have certain capabilities, including electronic prescribing, exchanging electronic health information, and submitting information on clinical quality measures and other measures as determined by the Secretary of Health and Human Services. The HIMSS definition for meaningful user specifically includes this criterion: demonstrates certified EHR technology is connected in a manner that provides, in accordance with law and standards applicable to the exchange of information, for the electronic exchange of health information to improve the quality of health care, such as promoting care coordination. 2

3 The HIMSS Health Information Technology Policy Committee, in its Meaningful Use Workgroup Recommendations and Call for Public Comment Summary, offers a broad summary of its recommendations:2 Data sharing by 2011 Incorporate data into establishing Advanced Clinical Processes by 2013 Improved outcomes through information sharing by 2015 The HIT Policy Committee defines the objectives (or outcomes) of meaningful use for the required levels of EHR technology implementation in 2011, 2013 and 2015 as:3 Improve quality, safety and efficiency Engage patients Improve care coordination Reduce health disparities through public and population health da ta-sharing Ensure privacy and security Demonstrating Meaningful Use EHR technology refers to any system (e.g. an HCIS - Health Care Information System) that contains patient records and securely maintains the information within those records. EHR technology provides reporting for all parties involved in patient care, as well as for meeting federal, state and industry requirements. EHR report data is exchanged securely with other systems and databases, including Electronic Medical Records (EMRs), ensuring real-time availability of patient information for maintaining optimal healthcare. Electronic Health Records (EHRs) are often confused with Electronic Medical Records (EMRs). In fact, the two terms are used interchangeably with other terms used in the field, specifically electronic patient record (EPR) and computerbased patient record (CPR). There are actually According to HIMSS, to be a meaningful user, an organization must have certain capabilities, including electronic prescribing, exchanging electronic health information, and submitting information on clinical quality measures and other measures as determined by the Secretary of Health and Human Services. two factions on this subject in the industry one believes the two terms mean the same thing, and the other maintains there are differences. Various definitions exist for what these differences are, but they are generally described as follows: EHR An EHR is an aggregate record of health-related information on a patient, including histories, reports, labs, pharmacy data, etc., and is shared by all stakeholders, i.e. the various healthcare providers, insurers and payers, as well as the patient. EMR An EMR is what is used and maintained by the healthcare provider (hospital, physician, or clinic) who created it. An EMR contains patient data related to the care received by that provider and is generally the source of data for the EHR.

4 Exchanging Electronic Health Data to Improve Quality of Care Healthcare providers implementing data interoperability obtain the ability to exchange key clinical data with physicians and labs and transfer and integrate data into physicians practice EMRs. In addition, data interoperability enables providers to ensure: The ARRA legislation has established healthcare data interoperability as one of the key requirements for demonstrating meaningful use. Patient information is transferred quickly and efficiently; While there may be a distinction between EHRs and EMRs, there is clearly a connection the exchange of information is a continuous occurrence between the EHR or HCIS system and EMRs with physicians offices and other providers. For healthcare providers, possessing the ability to better automate data exchanges between EHRs and EMRs is critical, mainly because it: Ensures that new patient information is received securely and in real-time, and patient records are consistently upto-date; Helps to keep down operational costs; and Increases operational efficiency and staff productivity The ARRA legislation has established healthcare data interoperability as one of the key requirements for demonstrating meaningful use. This is not only because data interoperability is an essential capability in the provider s healthcare IT system. For the nation as well as the healthcare industry, immediate and effortless data sharing and transfer is an important step toward ensuring consistent delivery of healthcare and raising the overall quality of patient care. Privacy and security of patient information is supported; Patient information is available to all parties involved in a patient s care (physicians, labs, etc.); and Patient information is up-to-date. By fully automating the transfer of new and updated data from the HCIS to EMRs and making it available in real time, healthcare organizations connect their doctors, staff and technical support to the information they need. By also guaranteeing access to that data during periods of system failure or extended downtime, healthcare organizations mitigate risks to patient care and safety. Lab results are accessible as soon as they become available, new or changed prescription information is communicated immediately, and changes in a patient s condition or treatment are transmitted to all applicable departments 24/7. Providers can depend on getting the information they need when they need it and no longer encounter challenges to treating their patients. Patients can be assured their health information and medical records are up-to-date and they are receiving the best possible care.

5 Meeting Data Interoperability Requirements for Demonstrating Meaningful Use A number of solutions exist that support meaningful use requirements for healthcare data interoperability. Whether healthcare organizations are implementing a new solution or replacing a current product, they should take into consideration several factors as they begin comparing offerings: HIPAA requirements; Their environment; Their specific needs; and Their budget. Providers can depend on getting the information they need when they need it and no longer encounter challenges to treating their patients. Patients can be assured their health information and medical records are up-to-date and they are receiving the best possible care. Once healthcare organizations start looking more closely at functionality, there are certain capabilities to look for. Healthcare organizations require the ability to transfer patient information and reports in a highly secure environment. An information distribution solution with data interoperability should enable hospitals and providers to both securely and easily send and retrieve patient information generated by the HCIS, providing reports in a format that is beneficial to the endusers. By also taking the reports generated by the HCIS and reformatting them into HL7 messages, a data interoperability solution allows easy integration to a physician s practice EMRs. Efficiency, flexibility and security are equally important qualities. With NetDelivery and the NetDelivery Integration Module, Interbit Data s information distribution software, data and reports generated by an HCIS are securely and reliably reformatted into HL7 messages and easily integrated in physicians EMRs. The data integration with physicians EMRs becomes as easy as printing a report. NetDelivery is all-inclusive, addressing the range of different requirements. The software is also flexible and accommodating, allowing healthcare providers to distribute data and reports easily to multiple recipients and via multiple methods. NetDelivery supports 14 distribution methods including fax, encrypted print stream, encrypted file and and four output file formats: PRN, TIF, TXT, and PDF. Users receive information how and where they want to receive it and in their choice of format.

6 Providing Further Protection to Patient Data To aid in achieving meaningful use as well as further protect patient data and records, healthcare organizations need a business continuance solution that will allow them to access important patient information during a healthcare IT system failure or downtime. Interbit Data s NetSafe enables hospitals and providers to automatically capture information from the HCIS anywhere on the network. Having up-todate information whenever it is needed further ensures the delivery of quality patient care. NetDelivery with the Integration Module can perform the HL7 data exchange with or without HCIS interfaces, further providing flexibility and a more cost-effective solution, as customers are not required to purchase a full suite of interfaces from the HCIS vendor. NetDelivery also transfers information in a highly secure manner. User connections to reports are password-protected and reports are encrypted prior to delivery, ensuring compliance with HIPAA regulations and improved protection of confidential patient information. While NetDelivery was primarily developed for enabling fast and efficient distribution and receipt of patient information, as well as integration with EMRs, it is suitable for other applications as well. Many hospitals have become creative with the software and are using it in other departments for sharing data and reports, such as payroll and billing. Support for Achieving Meaningful Use and Meeting ARRA Deadlines To help customers with meeting the deadlines for establishing meaningful use and satisfying ARRA health IT stimulus funding requirements, Interbit Data offers rapid deployment of NetDelivery with the Integration Module and fully supports each customer implementation. The company will work with healthcare customers to help ensure they are adopting the technologies that are essential for achieving meaningful use. An information distribution solution with data interoperability should enable hospitals and providers to both securely and easily send and retrieve patient information generated by the HCIS, providing reports in a format that is beneficial to the end-users.

7 Summary Healthcare organizations are driven to control costs, but without sacrificing patient care. In the process, they are challenged by HIPAA requirements and HL7 standards to maintain the privacy and security of patient information and records. Improvements in healthcare delivery will ultimately be driven by information technology, which is why one of the main provisions of ARRA is focused on strengthening the healthcare IT infrastructure. Healthcare organizations have the opportunity to receive economic stimulus funding by implementing EHR technologies and related solutions and demonstrating meaningful use of those technologies. One of the requirements for establishing meaningful use, the secure and efficient exchange of healthcare information, or data interoperability, entails obtaining the ability to take information generated by an HCIS system and integrate it into Physicians EMRs. NetDelivery with the Integration Module supports data interoperability by streamlining and securing the HL7 data transfer process. To ensure the uninterrupted availability of critical patient information and records, NetSafe provides data protection and business continuity during periods of network or system failure or downtime. The benefits for healthcare providers are improved efficiency, mitigated risk and a heightened overall ability to provide optimal patient care.

8 About Interbit Data, Inc. Founded in 1997, Interbit Data helps healthcare organizations deliver better, more consistent patient care with secure, reliable and cost-effective software solutions that improve operational efficiency. Interbit Data was named to the Inc. Magazine list of the 5,000 fastest growing private companies in the United States. The company ranked No as a result of achieving over 96% growth from 2005 to 2008, a growth rate that is 70% more than other companies in the same industry. Interbit Data products are used by more than 600 healthcare facilities worldwide. For more information about Interbit Data and its NetSolutions products, visit the company Website at WHITEPAPER CONNECT WITH US