Information technology is constantly advancing in every aspect of our lives and in healthcare it is taking center stage. The Evolution of Health Information Technology (HIT) over the years have improved the quality of healthcare services across the board and this cannot come at a better time when patients are demanding top-quality services. HIT has enabled patients to engage more in their care with the introduction patient portals, personal health records, mHealth, social media, telehealth and so on. This paper will discuss more on how Health Information Technology has influenced patient engagement with providers, discuss examples of organizations who have adopted technologies to improve patient engagement, vendors and the future of Health Information Technology.
Patient Engagement and Health Information Technology
When providers and patients work together, healthcare outcomes are significantly improved. Fortunately, nowadays patients are more engaged in the healthcare services they receive more than ever before especially in decision making process and this typically a determining factor of service satisfaction. Some professionals identify HIT responsible for the push for better patient engagement and that technology will improve the patient experience through seamless data access/exchange, care management and patient activation in care. Unfortunately, this is not always the case, some patient engagement tools intended to make healthcare more suitable and individualized are too completed and not user friendly for patients. This is true for some patient portals and mHealth platforms. While some healthcare providers are adopting the patient portals for its meaningful use requirements, some clinicians adopt the patient portal just of the sake of having it rather than maximizing its potential to benefit the patients.
Healthcare organizations now use big data to understand patients to better serve them. Data analysis and collection help providers make clinically informed decisions about their patients. The availability of data on demand enable fast and accurate information for Clinical Support Decision.
Case Study: Lahey Health System and Epic Systems
Lahey Health announced in 2013 to invest in electronic health record (EHR) software that will improve overall healthcare delivery especially in areas of accessibility to patient information and care coordination throughout the system. Epic systems was outsourced to carry out this EHR implementation which began in June of 2013. Howard Grant MD, then CEO of Lahey health recognized the EHR implementation as a major investment and stated that “It will enable our medical staff, affiliated physicians and other care providers to have secure, streamlined access to comprehensive electronic health information and data for their patients, in real time. It will allow for better and timelier decisions, and it will create efficiencies.” He added that “Most importantly, it will allow patients to become more engaged and more empowered in managing their health because it will allow providers and patients to share access to information.” It is safe to say that the organization recognized patient engagement as one of the top factors that encouraged the move for EHR implementation.
Lahey Health System is an organization based in Burlington Massachusetts with hospitals, primary care providers, specialist physicians, behavioral health services, post-acute programs such as home health services, skilled nursing and rehabilitation facilities, and senior care resources located throughout northeastern Massachusetts and southern New Hampshire. “Lahey Health is an integrated health care system committed to providing the full continuum of health care services close to where patients live and work. The system is comprised of nationally recognized, award-winning hospitals, physicians, behavioral health services, and post-acute programs including home health services, skilled nursing and rehabilitation facilities, and senior care resources”. Lahey Health Systems includes Lahey Hospital & Medical Center, teaching hospital of Tufts University School of Medicine and Lahey Clinic physician group with practices in Burlington, Peabody and other locations throughout northeastern Massachusetts and southern New Hampshire. Beverly Hospital; Addison Gilbert Hospital in Gloucester, MA; Lahey Health Senior Care and Lahey Health Behavioral Services as well as more than 30 primary care physician practices and multiple outpatient and satellite specialty care facilities.
Epic was founded in 1979 by Judy Faulkner in Madison WI, originally called Human Services Computing but was renamed 1983. Since then Epic has worked its way up as a privately held company to be a worldwide known leader in health information technology with more than 200 million patients with electronic health record on their platform. Now headquartered in Verona WI, Epic now offers products tailored to address various aspects of health IT operations, including population health management, patient engagement and revenue cycle management.
Epic experiences significant growth in client base when the Federal Government established EHR incentive programs in 2009 to promote the adoption of EHRs through meaningful use of the technology. In 2016, Epic revenue of over 2.5 billion dollars. Key products and services includes EpicCare, MyChart, Healthy Planet, revenue cycle management, Tapestry and mobile interfaces.
EHR Implementation Project
Before the implementation of the Epic EHR, Lahey recognized key aspects of the Epic system which will enhance care coordination across Lahey Health System. The implementation of the EHR was expected to improve communication among care providers and their patients, deliver accurate data at all times for providers and patients. Integrated data and analytics from the system will facilitate industry best practices to improve efficiency and enhance ability to better manage chronic diseases. This EHR implementation was also expected to improve patient engagement, health outcomes and satisfaction. There was arrangement for dedicated security team to protect patient information in the implementation plan, this will defend the EHR system from phishing, ransomware, system hacking and other cyber-attacks.
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The organization recognized how big of a change adoption of the EHR system will be, so there was training carried out across that Health System, potential users were encouraged to take part in seminars and be open minded towards this technology as it is never an easy task to adopt something totally new and different in a work space. Lahey consulted other organizations how have successfully adopted similar technology across the country, the report all around was the same staff members must be patient and open minded to the new system. Staff members were informed the benefit this EHR implementation a new tool that will be used to provide exceptional care to patients and their families. The Epic project took two years to complete and cost over 160 million dollars to successfully implement.
Epic went live at Lahey Health systems March 28, 2015, once the organization overcame the glitches and user started to get more inclined with the system it became a day-to-day routine. After the use of the EHR platform became part of everyday use and built into the workflow, it was determined that patients and their families where in the center of every decision made, over how much the implementation cost in dollars, man hours to successfully put the EPIC system in place, logistical issues, hours of trainings required of users and significant workflow readjustment. Patient centered care and engagement was the organizations one takeaway that made this technology makeover worth every resource put into it actualizing the EHR system.
Successes. In 2017, Lahey Health earned Stage 7 designation on HIMSS Analytics’ Electronic Medical Record Adoption Model (EMRAM) for both acute and ambulatory care. This is a highly rated achievement that only 5% of hospitals in the United States have achieved this level of HIMSS designation. Lahey health is the only Health system in Massachusetts to have earned this panicle and only fewer than 40 hospitals in the nation have earn this Stage 7 designation for both acute and ambulatory care. The adoption of the Epic EHR enabled Lahey develop a more comprehensive care environment which has always been a mission for Lahey Health system’s care continuum commitment for their patients and families. Lahey Health positioned itself to attain Stage 7 through a seamless integration of multiple hospitals, outpatient clinics, and provider offices throughout northeastern Massachusetts and southern New Hampshire. By combining the EMRAM algorithms across its infrastructure, Lahey Health has developed a mature high quality, high value EHR framework that provides clinicians a central hub for maximizing patient safety, medication administration, and point-of-care interactions.
Apart from a successful EHR platform, Lahey Health can provide patient portals through Epic to their patients and their families to access their health history anywhere and anytime. Epic’s Care Everywhere now allow providers from other institutions who use Epic to view patient’s information within the epic system by simply using the “outside record” feature.
Challenges. The organization suffered a major setback towards the end of the Epic project forcing the organization to lay off 130 staff members (95 people being laid off at Lahey Medical Center Burlington, 30 people at Winchester Hospital and 5 lay off at Beverly and Addison Gilbert Hospitals) to close the budget cap. Also, executives volunteered to a 10 percent cut in pay for the rest of that year.
The Epic project enabled Lahey health to seamlessly provide services across the health system which was exactly what they hoped to attain at the end of the implementation of the project. This allows services including primary care providers, specialist physicians, behavioral health, post-acute programs such as home health services, skilled nursing and rehabilitation facilities, and senior care resources all to be accessible in one place. When this is achieved, it is very likely that patient engagement will rise. Also, the availability of the patient portal gives patients a lot of control over their charts and health decision making.
- 10 things to know about Epic. (2017, January 20). Retrieved from https://www.beckershospitalreview.com/healthcare-information-technology/10-things-to-know-about-epic.html
- Bartlett, J. (2015, May 20). Lahey Health cutting workforce. Retrieved from https://www.bizjournals.com/boston/blog/health-care/2015/05/lahey-health-cutting-workforce.html
- Lahey Health. (2013, March 21). Lahey Health’s New EHR | Beverly Hospital. Retrieved from https://www.beverlyhospital.org/about-us/newsroom/press-releases/2013/lahey-health-invests-in-electronic-health-record-system
- Lahey Health. (2017, September 6). Lahey Health Earns HIMSS Analytics Stage 7 Designation – Lahey Health. Retrieved from https://www.laheyhealth.org/media-room/press-releases/2017/lahey-health-earns-himss-analytics-stage-7-designation/
- Part of Lahey Health layoffs due to cost of EHR rollout. (2015, May 22). Retrieved from https://www.beckershospitalreview.com/healthcare-information-technology/part-of-lahey-health-layoffs-due-to-cost-of-ehr-rollout.html
- PatientEngagementHIT. (2018, July 31). What Is the Future for Patient Engagement Technology, Health IT? Retrieved from https://patientengagementhit.com/news/what-is-the-future-for-patient-engagement-technology-health-it
- PR Newswire. (2013, March 28). Lahey Health Invests in New Electronic Health Record System for Better Coordinated Care. Retrieved from https://www.prnewswire.com/news-releases/lahey-health-invests-in-new-electronic-health-record-system-for-better-coordinated-care-200452421.html
- Project Epic Fact Sheet – Care Everywhere. (n.d.). Retrieved from https://projectepic.ynhh.org/Epic%20Newsletters%20and%20Fact%20Sheets/FAQ%20Care%20Everywhere.pdf
- What is Epic Systems? – Definition from WhatIs.com. (n.d.). Retrieved from https://searchhealthit.techtarget.com/definition/Epic-Systems-Corp
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