Operating on thin margins, outside the reach of federal health IT adoption incentives, long-term care facilities likely still store data on paper and have little or no means to receive data electronically. "A lot of the challenge is on that side of the business, unfortunately," says Ferdinand Velasco, M.D., chief medical information officer of Texas Health Resources. The Arlington-based health system has initiated post-acute partnerships, but faces a steep technology climb in establishing meaningful information exchange.
The days of dismissing telemedicine as a mere technology option are over. Advances and refinements in the delivery of health care through audiovisual connections are powering not just individual "visits" between clinicians and patients, but entirely different ways to spread specialty expertise around, cover shortages of medical professionals, compete in metropolitan areas and anticipate health reform.
The days of dismissing telemedicine as a mere technology option are over. Advances and refinements in the delivery of health care through audiovisual connections are powering not just individual "visits" between clinicians and patients, but entirely different ways to spread specialty expertise around, cover shortages of medical professionals, compete in metropolitan areas and anticipate health reform as well.
Monitoring the health of not-so-healthy people gets tricky once they leave the hospital or physician clinic and head home. The previous extent of home-based management included visits from nurses, phone calls and other labor-intensive activities.
The continuum of care requires continual communication and information sharing to tie it together, and that involves computerized equipment that clinicians and patients understand, are familiar with and will gladly use. The proliferation of cellphones, their morphing into miniature computers and the addition of wireless tablet computers have become a ready base for health-related information interchange.
Continuum of care is not fully connected until it's connected to patients who are actively engaged in their health. It's the end game in the "end-to-end" integration of care that the health care industry talks so much about.
Organizing for the team-oriented tenets of a patient-centered medical home involves a whole lot more sophistication than is typically found in primary care physician practices, especially when it comes to health information technology. That’s because much of IT at the primary care level is built for that traditional practice.
Analyze this: You've assembled a strategically sound continuum of care. Information systems are connecting each site to one another as well as pulling data from all of them. Data are flowing — gushing — into a data warehouse, coalescing into registries that identify people at health risk. But for the most part, it's just potential for action. Where do you find the know-how and technological tools to harvest it all?
The infrastructure connecting a health care organization's continuum of care may be in place — electronic health record systems dialing up other sites of care, accepting lab, medication and other critical patient data from outside the hospital's four walls — but it still largely remains a mass of potential. Tapping that potential requires tools to turn information into population management leads and aids.
It was once about the technology. Health information exchange — that set of activities concerned with getting clinical documentation from the places where it was created to other places that could really use the information — lacked some basic components: a critical mass of computer systems to create discrete data; standards allowing data from one electronic health record to be taken in by another; and routine methods to transmit the data anywhere it needed to go.
New models of providing care and getting paid for it have made yesterday's stretch goals for information technology today's basic building blocks. "We've made major investments in the past that are considered table stakes today, just to get going," says Ed Marx, senior vice president and chief information officer of Texas Health Resources, Arlington, which has spent big on clinical IT.