EHRs and Interoperability

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201606_CT_NovDec_2016_Web

When
the federal government decided to provide financial incentives to
physicians and hospitals to install electronic health record (EHR)
systems, this sounded like a way to jump-start the use of computer
technology in order to improve patient care and make it a more
efficient process. But the financial incentives were predicated on the
use of these EHRs in a meaningful way, based on the federal government
meaningful use requirements.

There
was another reason to push the use of EHRs. This was interoperability
to allow sharing of patient information from different systems.

The
federal government has poured billions of dollars into the EHR
meaningful use program. The government is now auditing physician
practices and hospitals to verify their attestation that they are
using the systems according to the meaningful use requirements.

But
are EHRs improving efficiency? From what I have read there have been
more negatives than positives on this point. These systems are
increasing the time spent per patient encounter, answering all the
prompts that come up on the screen. This is eating into the profits of
a physician practice, since not as many patients can be seen during
office hours.

As
far as the interoperability of systems goes, this is a far cry from
reality. Health information exchanges (HIEs), by design, were supposed
to facilitate interoperability, but different EHR systems still cannot
readily exchange data. Moreover, the health information exchange model
requires a buy-in from all the players in order to provide the
financial support needed to keep these exchanges viable. My take is
that quite a few HIEs are not seeing the buy-in.

In
pharmacy there is growing interest in having more data on a patient’s
medical history than just the drugs prescribed. There is interest in
having access to diagnoses and lab test results. There is interest in
being involved in transition of care when a person is discharged from
the hospital. There is interest in being involved in chronic care
management.

The
computer systems used today in pharmacy are still very much
transaction-processing systems at their core. However, what I see is a
trend in building in more patient care functionality. While
transaction processing will still be the backbone of these systems to
serve one role of pharmacy — filling prescriptions and handling the
insurance billing — these systems are being built out to accommodate
EHR and patient management functionality.

It
would be nice to see pharmacists become recognized providers under
Medicare. I feel one way to help this cause is to demonstrate how the
pharmacy management systems are evolving to enhance the role of
pharmacists in transition of care and chronic care management. Also,
there are already current procedural terminology (CPT) codes specific
to pharmacy. I give pharmacy credit for moving forward without
government financial incentives.
CT

Bill
Lockwood
,
chairman/publisher,
can be reached at wal@computertalk.com.

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