Enhancing Information Management in Health Care

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Keywords: ECM, EHR, process, health care, Information, emr, reform, patient records, digital

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A common topic of discussion in my classes and at various speaking engagements is how digital patient records are here and there is no place to hide from it. The mandate came early from President Obama and was soon followed by another mandate regarding the reporting of information breaches with respect to patient records. While these are now in play, several entities moved quickly to provide guidelines on how to accomplish this task of managing patient records more efficiently and securely which introduced us to the term meaningful use and that healthcare providers must be able to prove meaningful use of technology in order to comply and potentially qualify for available funding to supplement costs.

According to HIMSS (Healthcare Information and Management Systems Society), the level of "meaningful use" is accomplished when the EHR (Electronic Health Records) solution/technology, has capabilities to e-prescribe, exchange electronic health information to improve the quality of care, the capacity to provide clinical decision support to support practitioner order entry, and ability to submit clinical quality measures - and other measures - as selected by the Secretary of Health and Human Services. All of this is a good thing and I am very much in favor of it all but there are still a few things I feel need be said and brought to light.

In my view, this is long overdue and while there is good focus on the issue and a lot of momentum to move in a more digital direction, there is more to a patient record than one might think. Aside from the obvious diagnostic and prescriptive aspects of this discussion, there is the administrative side of healthcare as well. A full set of patient records will include additional information like insurance, financials, special orders like a DNR (Do Not Resuscitate), and more. Add to this the need to exchange information across organizations and between organizations, a part of the overall reason for this mandate and it opens the question of interoperability and format standards. Then there is the process factor. It is great to go digital, but are the supporting processes suited to these changes both internally and with external players.

To achieve meaningful use as defined is one thing but to truly be useful and effective takes more effort and extension across and beyond an enterprise. Improvement in our information management practices and supporting processes – a topic on the Keynote Panel in which I will participate next week in Chicago at the World Congress Leadership Summit on Process Improvement and Business Excellence in Health Care - that enable us to maximize our efficiencies and effectiveness throughout the enterprise. This is where I see a complementary fit between EHR and ECM (Enterprise Content Management) in that under an ECM umbrella, using established standards and practices for records and process management, health care organizations can truly benefit in information sharing and meeting the goals of meaningful use through interoperability, flexibility and extension across and beyond the enterprise. EHR focused on its purpose and ECM taking to to the enterprise level and a more standardized environment.

What say you? Do you have a story to tell? What are your thoughts on this topic? What is on your mind? Do you have a topic of interest you would like discussed in this forum? Let me know.

Email: Bob Larrivee, Director and Industry Advisor - AIIM

Email: blarrivee@aiim.org    Twitter – BobLarrivee

www.aiim.org/training

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Peter Lange

Applying ECM technology and principles to Healthcare makes a lot of sense, and you have an important point.

One aspect of information management in hospitals is to provide all relevant clinical information through specialized clinical applications, but one should - as you point out - not forget the administrative backoffice operations where clinical care is turned into claims and invoices. ECM with BPM has an important role in streamlining what is sometimes referred to as "the revenue cycle"(claims out - money in).

These processes shall be streamlined and maintain what is sometimes referred to as "the legal health record" which is the record that documents all the claims and the corresponding required clinical documents. So you are right; there is more to a patient record than one might think and ECM can drive down operational cost which will allow hospitals to shift resources to care.

Now, when it comes to sharing and exchange of information you are touching an important dimension. The exchange of claims information including unstructured data ("claims attachments") is well supported and enabled by the HIPAA standards that address interoperability and format standards. This is maybe not fully utilized and leveraged by the healthcare providers, but standardization is pretty mature.

So I agree; there is a great business case for ECM in Healthcare and it starts in the claims cycle.

However; what concerns you and me as patients/consumers is the quality of care which frequently depends on access to clinical information. So an even more valuable view on ECM in Healthcare is how it can be used as a platform to unify and share clinical information.

So, taken for given that your local hospital have done their homework and have streamlined backoffice, how can ECM take it to the next level by supporting an elaborated manner of sharing and exchange that supports privacy and security?



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What a utilization of tools and effects you did, It's really amazing work, I am inspired by your work and obviously this blog is perfect.

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