Electronic systems help physicians recall test results without the need for a patient to repeat them. They can also help with medication alerts and optimize adherence to guidelines.
Patient Engagement
Health information technology provides patients with the tools they need to manage their own health, as well as to engage in active healthcare participation. Whether through patient portals, telehealth, or other software solutions, HIT helps nudge patients to follow through with appointments and other care-related tasks that often get neglected after a doctor visit.
Health IT can also support one of the strongest tenets of nursing – educating the patient and family members. Patient engagement solutions provide a way for health providers to capture standardized data that can be shared across clinical settings, and can lead to better informed decision making by the patient and their families.
Hospitals that deploy patient engagement HIT functionalities are more likely to have lower 30-day readmission rates for pneumonia, heart failure and myocardial infarction. It can also increase overall patient satisfaction and perceived care quality.
However, the effectiveness of these tools is not always clear. A study published in the journal “Journal of Medical Internet Research” suggests that the success of patient portals tethered to EHRs depends on the extent to which they are useful and usable by the hospitalized population. This includes the breadth of features offered by the portal, as well as whether those functionalities are integrated into other applications like electronic medical records or telehealth programs. The study’s findings also indicate that implementation success should be measured using the technology acceptance model (TAM), which measures individual’s commitment and use of the technology.
Patient Safety
Health information technology can increase patient safety by increasing legibility of medical records and allowing easier access to and retrieval of health data. It also can help to improve medication safety by reducing errors in dispensing and administration, and it can facilitate tracking and reporting of adverse events and compliance with guidelines.
However, a number of issues can affect the effectiveness of health information technology on patient safety. A glaring example is the computerized physician order entry (CPOE) and clinical decision support system (CDS) errors that can occur because of human error, such as overriding alerts or prefilled templates used for convenience. These errors can result in the wrong prescription being sent to a pharmacy, or being administered to a patient.
Similarly, a CDS error can happen when a nurse misinterprets a physician’s instructions or accidentally overwrites a previous order with a new one. Another example is a hospital’s digital system displaying a duplicate patient name or medical history, or an inadvertent entry of a patient into the wrong treatment plan.
As the healthcare industry moves increasingly towards electronic record systems, qualified professionals who understand how to use these systems will be in high demand. Career options include health information technologists, coding specialists and meaningful use analysts who ensure that compliance procedures are followed. These individuals work on a daily basis to maintain, analyze and organize the massive amounts of data that are recorded in healthcare.
Patient Access to Information
Patient access refers to the ability of patients to review their own data and medical records, as well as communicate with healthcare providers directly. This aspect of health information technology has been increasingly prioritized, driven by consumer demands for greater control and transparency over their medical records. Digital applications and software, such as patient portals and telemedicine services, are helping to address this need by offering direct communication between patients and their doctors.
Despite the increased emphasis on patient access, there remains a large amount of work to be done in this area. For example, the Medicare EHR Incentive Program (Medicare EHR) has found that only a small proportion of patients are offered the opportunity to electronically access their health records by their healthcare providers. This may be due to lower rates of digital and health literacy or a lack of broadband connection at home.
Additionally, there is a need to ensure that the data being accessed is accurate. This is a goal of CPOE, which can provide alerts to minimize pharmacological errors, optimize medication safety through legibility and reduce adherence issues by tracking and reporting consultations, diagnostic testing and outcomes.
Finally, the patient experience is also improved by tools that facilitate faster processing of registration and billing. These automation features reduce manual labor and free staff to focus on more critical tasks. This is an important consideration for healthcare providers, which face shortages of clinical and administrative staff.
Interoperability
Interoperability is a way for different systems and software to communicate with each other. It is the basis for streamlined healthcare processes that improve data sharing and patient outcomes.
The goal is to enable healthcare providers to send and receive information regardless of which system the data originated in or the system it is sent to. It would mean that your doctor’s office could see the results of your lab test from your hospital visit, or a radiologist can access your family doctor’s EHR data to see previous diagnoses, treatments, and medications.
Achieving robust interoperability requires a collaborative approach and is the responsibility of both the federal government and the private sector. The government needs to convene experts and establish clear standards for end-to-end interoperability.
Ideally, the government will not require specific products or technologies to meet those standards; rather, it should promote the infrastructure and incentives to encourage broad adoption of interoperable systems. Future Meaningful Use programs should focus on lowering barriers, streamlining heterogeneous policies, and providing incentives to exchange high-value data.
There are three levels of interoperability: foundational, structural, and semantic. The first level, foundational, involves ensuring that one information system can receive data from another. Structural interoperability focuses on how that data is formatted. Semantic interoperability provides the highest level of connectivity, using common terminologies and standardized coding to interpret the data. Examples of these include Logical Observation Identifiers Names and Codes (LOINC) for laboratory observations, HGNC for gene nomenclatures, and Human Phenotype Ontology for phenotypic abnormalities.