Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and HIPAA for FREE!!

Healthcare CIOs Focus On Optimizing EMRs

Posted on March 30, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Few technical managers struggle with more competing priorities than healthcare CIOs. But according to a recent survey, they’re pretty clear what they have to accomplish over the next few years, and optimizing EMRs has leapt to the top of the to-do list.

The survey, which was conducted by consulting firm KPMG in collaboration with CHIME, found that 38 percent of CHIME members surveyed saw EMR optimization as their #1 priority for capital investment over the next three years.  To gather results, KPMG surveyed 122 CHIME members about their IT investment plans.

In addition to EMR optimization, top investment priorities identified by the respondents included accountable care/population health technology (21 percent), consumer/clinical and operational analytics (16 percent), virtual/telehealth technology enhancements (13 percent), revenue cycle systems/replacement (7 percent) and ERP systems/replacement (6 percent).

Meanwhile, respondents said that improving business and clinical processes was their biggest challenge, followed by improving operating efficiency and providing business intelligence and analytics.

It looks like at least some of the CIOs might have the money to invest, as well. Thirty-six percent said they expected to see an increase in their operating budget over the next two years, and 18 percent of respondents reported that they expect higher spending over the next 12 months. On the other hand, 63 percent of respondents said that spending was likely to be flat over the next 12 months and 44 percent over the next two years. So we have to assume that they’ll have a harder time meeting their goals.

When it came to infrastructure, about one-quarter of respondents said that their organizations were implementing or investing in cloud computing-related technology, including servers, storage and data centers, while 18 percent were spending on ERP solutions. In addition, 10 percent of respondents planned to implement cloud-based EMRs, 10 percent enterprise systems, and 8 percent disaster recovery.

The respondents cited data loss/privacy, poorly-optimized applications and integration with existing architecture as their biggest challenges and concerns when it came to leveraging the cloud.

What’s interesting about this data is that none of the respondents mentioned improved security as a priority for their organization, despite the many vulnerabilities healthcare organizations have faced in recent times.  Their responses are especially curious given that a survey published only a few months ago put security at the top of CIOs’ list of business goals for near future.

The study, which was sponsored by clinical communications vendor Spok, surveyed more than 100 CIOs who were CHIME members  — in other words, the same population the KPMG research tapped. The survey found that 81 percent of respondents named strengthening data security as their top business goal for the next 18 months.

Of course, people tend to respond to surveys in the manner prescribed by the questions, and the Spok questions were presumably worded differently than the KPMG questions. Nonetheless, it’s surprising to me that data security concerns didn’t emerge in the KPMG research. Bottom line, if CIOs aren’t thinking about security alongside their other priorities, it could be a problem.

Nursing Informatics Pros Seeing Growing Salaries, Opportunities

Posted on March 24, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Here’s something I missed in the explosion of news around HIMSS17. According to a recent study released late last month by the organization, nurse informaticists are largely well-paid and satisfied with their jobs.

According to the American Nurses Association, nurse informaticists have broad responsibilities, including integrating data and supporting provider and patient decision-making. The job description continues evolve with health IT trends, and may vary from one institution to the other,but their work usually involves a mix of nursing science, health records management and information technology solutions.

As the job description has solidified, nursing informatics has begun to become a well-liked specialty. Eighty percent of respondents to the HIMSS study, the 2017 Nursing Informatics Workforce Survey, reported being satisfied or highly satisfied with their careers, HIMSS found. This may be in part due to their pay, with almost half respondents telling researchers that they had a base salary of over $100,000. Not only that, 34 percent said they also got a bonus.

Meanwhile, highly-trained nursing informaticists did better still. Those who had gotten a nursing informatics certification or post-graduate degree took home higher salaries than those who hadn’t. With over half of those who had additional education made more than $100,000 a year, as opposed to 37 percent of those who didn’t, the trade group said.

In addition, nurse informaticists are advancing themselves to a striking degree, with over half of respondents having a post-graduate degree, often in informatics or nursing informatics, HIMSS reported. (Of this group, 57 percent had completed post-graduate degrees, and 29 percent had a master’s degree or PhD in informatics.)

Meanwhile, 41 percent of nurses are involved in a formal informatics program, and almost half had a certification. These efforts seem be paying off, with two-fifths of respondents reporting that they moved into a new position with more responsibility after they got certified.

As nurse informaticists grow, they are accumulating deeper levels of experience.  All told, 31 percent of respondents had more than 10 years of informatics experience, 36 percent had five to 10 years of experience – dwarfing the 24 percent that had just one to four years. One-third of respondents said they’d been in their current position for more than five years, and a majority of respondents reported having seven years plus of related experience.

While these nurses seem like they enjoy their careers, they are still facing some bureaucracy-related problems.  For example, when asked about their concerns, they rated a lack of administrative and staffing resources as the top barrier to their success.

Ongoing shifts in their reporting roles may also be leading to some dissatisfaction. While most respondents told HIMSS that they reported to the information systems or tech department of their organization, a growing number report to administrative or corporate headquarters. (On the other hand, one-third said that their organization has a senior nursing informatics executive or CNIO, which one would hope proves to offer extra support.)

Though the HIMSS summary doesn’t say so explicitly, it seems very likely that demand for nurse informaticists is outstripping supply, given the substantial salaries these experts can command. If your organization needs to recruit such a person, be prepared for some tough competition.

HIMSS17: Health IT Staff, Budgets Growing

Posted on March 1, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A new study announced last week at the HIMSS17 event concludes that demand for health IT staff continues to grow as employers expand their budgets. Not surprisingly, given this growth, the healthcare employers are having trouble recruiting enough IT staffers to meet their growing needs.

Results from the HIMSS Leadership and Workforce Survey reflect responses from 368 U.S. health IT leaders made between November 2016 and early January 2017. Fifty-six of respondents from vendors and consulting firms were in executive management, as compared with 41% of providers.

The survey concluded that the majority of health IT respondents have positions they’d like to fill, including 61% of health IT vendors/consultants and 43% of providers who responded. Only 32% of vendor/consultant organizations and 38% or providers said they were fully staffed, HIMSS said. We’ve seen this challenge from many of the healthcare IT companies which post their jobs on Healthcare IT Central.

Demand for IT recruits grew last year, as well. Researchers found that 61% of vendors/consultants responding and 42% of providers responding saw IT staffing increases over the past year, and that the majority of respondents in both groups expect to increase their IT staffing levels or at least hold them steady next year.

Of course, someone has to pay for these new team members. HIMSS researchers found that IT budgets were continuing to rise over time. Roughly nine out of ten vendors/consultants and 56% of providers said they expected to see increases in their IT budgets this year.

As often happens, however, vendors and consultants and providers seem to have different HIT priorities. While vendors seem to be addressing new technology issues, providers are still focused on how to manage their existing EMR infrastructure investments, HIMSS said.

That being said, the survey found, health IT stakeholders have many overlapping concerns, including privacy and security, population health, care coordination and improving the culture of care.

One of the key insights from this study – that vendors/consultants and providers have different views on the importance of enhancing existing EMRs – is borne out by another study released at the HIMSS event.

The study, which was backed by voice recognition software vendor Nuance Communications, found that providers are broadly interested in implementing new technologies that enhance their EMR, especially computer-assisted physician documentation, mobility and speech recognition tools.

However, when asked to be specific about which tools interested them, they were less enthusiastic, with 44% showing an interest in mobility tools, 38% computer-assisted physician documentation and 25% speech recognition. Documentation tools that enhanced existing functions were especially popular, with 54% of respondents expecting to see them support a reduction in denied claims, 52% improved performance under bundled payments, 38% reduced readmissions and 38% better physician time management which improves patient flow.

This survey also found that the most popular strategy for enhancing physician satisfaction with health IT tools was providing clinician training and education (chosen by 82%). Since their EMR is probably their biggest IT investment, my guess is that the training will focus there. And that suggests that EMRs are still the center of their universe, doesn’t it?

Patient Misidentification Remains Common

Posted on February 27, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

The following information was released several weeks ago, but I just found it and thought readers would still find it relevant. The research, from security researcher Ponemon Institute, concludes that patient misidentification is relatively common and continues to impact patient safety and experience.

Late last year, Ponemon surveyed 503 healthcare professionals from across the US, including nurses, physicians, IT practitioners and leaders in financial operations, on the frequency and root causes of patient misidentification, as well as the consequences.

According to the researchers, 86% of respondents said they’d witnessed or know of medical errors resulting from patient misidentification. And 67% said that when searching for patient information, they find duplicate medical records for that patient almost all of the time. Along the way, about three-quarters of respondents agreed that use of biometrics could reduce patient misidentification and by extension, cut down on medical errors.

The most common root cause of patient misidentification was incorrect identification at registration (chosen by 63%), followed by time pressure when treating patients (60%), insufficient employee/clinician training and awareness (35%), too many duplicate medical records in system (34%), registrar errors (32%), turf wars between departments (29%), inadequate safety procedures (20%), over-reliance on homegrown or obsolete identification systems (15%) and misinformation provided by patient (9%). (The remaining 3% was reported as “other”.)

The key causes of misidentification named in the survey included the inability to find a patient’s chart or medical record (68% of respondents), a search or query which brings up multiple or duplicate medical records for a patient (67%), patient associated with incorrect records due to same names and/or dates of birth (56%), or having the wrong record pulled up for a patient because another record in the registration system or EMR has the same name and/or date of birth (61%).

Not surprisingly, the survey also suggests that widespread patient misidentification can have a serious financial impact. On average, Ponemon says, respondents said that more than one-third of all denied claims resulted directly from an inaccurate patient identification or inaccurate/incomplete information. This costs the average healthcare facility $1.2 million per year, they reported.

Meanwhile, patient identification problems have a negative impact on patient experience, the survey concluded. Sixty-nine percent of respondents told researchers that staff spent up to or more than 30 minutes per shift contacting medical records or HIM departments to get critical patient information.

Not only that, misidentifying patients can have a ripple effect, with missing or incomplete information leading to patient care delays. Thirty-seven percent of respondents said that they spent an hour or more contacting medical records or HIM departments to get critical patient information.

Consumers Fear Theft Of Personal Health Information

Posted on February 15, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Probably fueled by constant news about breaches – duh! – consumers continue to worry that their personal health information isn’t safe, according to a new survey.

As the press release for the 2017 Xerox eHealth Survey notes, last year more than one data breach was reported each day. So it’s little wonder that the survey – which was conducted online by Harris poll in January 2017 among more than 3,000 U.S. adults – found that 44% of Americans are worried about having their PHI stolen.

According to the survey, 76% of respondents believe that it’s more secure to share PHI between providers through a secure electronic channel than to fax paper documents. This belief is certainly a plus for providers. After all, they’re already committed to sharing information as effectively as possible, and it doesn’t hurt to have consumers behind them.

Another positive finding from the study is that Americans also believe better information sharing across providers can help improve patient care. Xerox/Harris found that 87% of respondents believe that wait times to get test results and diagnoses would drop if providers securely shared and accessed patient information from varied providers. Not only that, 87% of consumers also said that they felt that quality of service would improve if information sharing and coordination among different providers was more common.

Looked at one way, these stats offer providers an opportunity. If you’re already spending tens or hundreds of millions of dollars on interoperability, it doesn’t hurt to let consumers know that you’re doing it. For example, hospitals and medical practices can put signs in their lobby spelling out what they’re doing by way of sharing data and coordinating care, have their doctors discuss what information they’re sharing and hand out sheets telling consumers how they can leverage interoperable data. (Some organizations have already taken some of these steps, but I’d argue that virtually any of them could do more.)

On the other hand, if nearly half of consumers afraid that their PHI is insecure, providers have to do more to reassure them. Though few would understand how your security program works, letting them know how seriously you take the matter is a step forward. Also, it’s good to educate them on what they can do to keep their health information secure, as people tend to be less fearful when they focus on what they can control.

That being said, the truth is that healthcare data security is a mixed bag. According to a study conducted last year by HIMSS, most organizations conduct IT security risk assessments, many IT execs have only occasional interactions with top-level leaders. Also, many are still planning out their medical device security strategy. Worse, provider security spending is often minimal. HIMSS notes that few organizations spend more than 6% of their IT budgets on data security, and 72% have five or fewer employees allocated to security.

Ultimately, it’s great to see that consumers are getting behind the idea of health data interoperability, and see how it will benefit them. But until health organizations do more to protect PHI, they’re at risk of losing that support overnight.

AMIA Asks NIH To Push For Research Data Sharing

Posted on January 23, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

The American Medical Informatics Association has is urging leaders at the NIH to take researchers’ data sharing plans into account when considering grant proposals.

AMIA is responding to an NIH Request for Information (topic: “Strategies for NIH Data Management, Sharing and Citation”) was published in November 2016. In the RFI, it asked for feedback on how digital scientific data generated by NIH-funded research should be managed and disclosed to the public. It also asked for input on how to set standards for citing shared data and software.

In its response, AMIA said that the agency should give researchers “institutional incentives” designed to boost data sharing and strengthen data management. Specifically, the trade group suggested that NIH make data sharing plans a “scoreable” part of grant applications.

“Data sharing has become such an important proximal output of research that we believe the relative value of a proposed project should include consideration of how its data will be shared,” AMIA said in its NIH response. “By using the peer-review process, we will make incremental improvements to interoperability, while identifying approaches to better data sharing practices over time.”

To help the agency implement this change, AMIA recommended that applicants earmark funds for data curation and sharing as part of the grants’ direct costs. Doing so will help assure that data sharing becomes part of research ecosystems.

AMIA also recommends that NIH offer rewards to scholars who either create or contribute to publicly-available datasets and software. The trade group argues that such incentives would help those who create and analyze data advance their careers. (And this, your editor notes, would help foster a virtuous cycle in which data-oriented scientists are available to foster such efforts.)

Right now, to my knowledge, few big data integration projects include the kind of front-line research data we’re talking about here.  On the other hand, while few community hospitals are likely to benefit from research data in the near term, academic medical organizations are having a bit more luck, and offer us an attractive picture of how things could be.

For example, look at this project at Vanderbilt University Medical Center which collects and manages translational and clinical research data via an interface with its EMR system.

At Vanderbilt, research data collection is integrated with clinical EMR use. Doctors there use a module within the research platform (known as REDCap) to collect data for prospective clinical studies. Once they get their research project approved, clinicians use menus to map health record data fields to REDCap. Then, REDCap automatically retrieves health record data for selected patients.

My feeling is that if NIH starts pushing grantees to share data effectively, we’ll see more projects like REDCap, and in turn, better clinical care supported by such research. It looks to me like everybody wins here. So I hope the NIH takes AMIA’s proposal seriously.

Time To Treat Telemedicine as Just “Medicine”

Posted on October 25, 2016 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Over the last year or two, hospitals and clinics have shown a steadily growing interest in offering telemedicine services. Certainly, this is in part due to the fact that health plans are beginning to pay for telehealth consults, offering a new revenue stream that providers want to capture, but there’s more to consider here.

Until recently, much of the discussion around telehealth centered on how to get health insurance companies to pay for it. But now, as value-based purchasing becomes more the norm, providers will need to look at telemedicine as a key tool for managing patient health more effectively.

Evidence increasingly suggests that making providers available via telemedicine channels can help better manage chronic conditions and avert needless hospitalizations, both of which, under value-based payments, are more important than getting a few extra dollars for a consult.

Looked at another way, the days of telehealth being a boutique service for more-sophisticated consumers are ending. “It’s time to treat telemedicine as just ‘medicine,’” one physician consultant told me. “It’s no different than any other form of medicine.”

As reasons for treating telehealth as a core clinical service increase, barriers to sharing video and other telemedical records are falling, the consultant says. Telemedicine providers can already push the content of a video visit or other telehealth consult into an EMR using HL7, and soon information sharing should go both ways, he notes.

What’s more, breaking down another wall, major EMR vendors are offering providers the ability to conduct a telehealth visit using their platform. For example, Epic is offering telemedicine services to providers via its MyChart portal and Hyperspace platform, in collaboration with telehealth video provider Vidyo. Cerner, which operates some tele-ICUs, has gone even further, with senior exec John Glaser recently arguing that telehealth needs to be a central part of its population health strategy.

Admittedly, even if providers develop a high level of comfort delivering care through telehealth platforms, it’s probably too soon to rely on this medium as an agent of change. If nothing else, the industry must face up to the fact that telemedicine demand isn’t huge among their patients at present, though consumer plays like AmWell and DoctoronDemand are building awareness.

Also, while scheduling and conducting telemedicine consults need not be profoundly different than holding a face-to-face visit — other than offering both patient and doctor more flexibility — working in time to manage and document these cases can still pose a workflow challenge. Practical issues such as how, physically, a doctor documents a telehealth visit while staring at the screen must be resolved, issues of scheduling addressed and even questions of how to store and retrieve such visit records must be thought through.

However, I think it’s fair to say that we’re past wondering whether telemedicine should be part of the healthcare process, and whether it makes financial sense for hospitals and clinics to offer it. Now we just have to figure out where and when.

E-Patient Update: The Patient Data Engagement Leader

Posted on October 20, 2016 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

As healthcare delivery models shift responsibility for patient health to the patients themselves, it’s becoming more important to give them tools to help them get and stay healthy. Increasingly, digital health tools are filling the bill.

For example, portals are moving from largely billing and scheduling apps to exchanging of patient data, holding two-way conversations between patient and doctor and even tracking key indicators like blood glucose levels. Wearables are slowly becoming capable of helping doctors improve diagnoses, and patterns revealed by big data should soon be used to create personalized treatment plants.

The ultimate goal of all this, of course, is to push as much data power as possible into the hands of consumers. After all, for patients to be engaged with their health, it helps to make them feel in control, and the more sophisticated information they get, the better choices they can make. Or at least that’s how the traditional script reads.

Now, as an e-patient, the above is certainly true for me. Every incremental improvement in the data I get me brings me closer to taking on otherwise overwhelming health challenges. That’s true, in part, because I’m comfortable reading charts, extrapolating conclusions from data points and visualizing ways to make use of the information. But if you want less tech-friendly patients to get on board, they’re going to need help.

The patient engagement leader

And where will that help come from? I’d argue that hospitals and clinics need to create a new position dedicated to helping engage patients, including though not limited to helping them make their health data their own. This position would cut across several disciplines, ranging from patient health education clinical medicine to data analytics.

The person owning this position would need to be current in patient engagement goals across the population and by disease/condition type, understand the preferred usage patterns established by the hospital, ACO, delivery network or clinic and understand trends in health behavior well enough to help steer patients in the right direction.

It also wouldn’t hurt if such a person had a healthy dose of marketing skills under their belt, as part of the patient engagement process is simply selling consumers on the idea that they can and should take more responsibility for their health outcomes. Speaking from personal experience, a good marketer can wheedle, nudge and empower people by turns, and this will be very necessary to boost your engagement.

While this could be a middle management position, it would at least need to have the full support of the C-suite. After all, you can’t promote population-wide improvements in health by nibbling around the edges of the problem. Such measures need to be comprehensive and strategic to the mission of the healthcare organization as a whole, and the person behind the needs to have the authority to see them through.

Patients in control

If things go right, establishing this position would lead to the creation of a better-educated, more-confident patient population with a greater sense of self efficacy regarding their health. While specific goals would vary from one healthcare organization to the other, such an initiative would ideally lead to improvements in key metrics such as A1c levels population-wide, drops in hospital admission and readmission rates and simultaneously, lower spending on more intense modes of care.

Not only that, you could very well see patient satisfaction increase as well. After all, patients may not feel capable of making important health changes on their own, and if you help them do that it stands to reason that they’ll appreciate it.

Ultimately, engaging patients with their health calls for participation by everyone who touches the patient, from techs to the physician, nurses to the billing department. But if you put a patient engagement officer in place, it’s more likely that these efforts will have a focus.

What Do You Think Of Data Lakes?

Posted on October 4, 2016 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Being that I am not a high-end technologist, I’m not always up on the latest trends in database management – so the following may not be news to everyone who reads this. As for me, though, the notion of a “data lake” is a new one, and I think it a valuable idea which could hold a lot of promise for managing unruly healthcare data.

The following is a definition of the term appearing on a site called KDnuggets which focuses on data mining, analytics, big data and data science:

A data lake is a storage repository that holds a vast amount of raw data in its native format, including structured, semi-structured and unstructured data. The data structure and requirements are not defined until the data is needed.

According to article author Tamara Dull, while a data warehouse contains data which is structured and processed, expensive to store, relies on a fixed configuration and used by business professionals, a data link contains everything from raw to structured data, is designed for low-cost storage (made possible largely because it relies on open source software Hadoop which can be installed on cheaper commodity hardware), can be configured and reconfigured as needed and is typically used by data scientists. It’s no secret where she comes down as to which model is more exciting.

Perhaps the only downside she identifies as an issue with data lakes is that security may still be a concern, at least when compared to data warehouses. “Data warehouse technologies have been around for decades,” Dull notes. “Thus, the ability to secure data in a data warehouse is much more mature than securing data in a data lake.” But this issue is likely to receive in the near future, as the big data industry is focused tightly on security of late, and to her it’s not a question of if security will mature but when.

It doesn’t take much to envision how the data lake model might benefit healthcare organizations. After all, it may make sense to collect data for which we don’t yet have a well-developed idea of its use. Wearables data comes to mind, as does video from telemedicine consults, but there are probably many other examples you could supply.

On the other hand, one could always counter that there’s not much value in storing data for which you don’t have an immediate use, and which isn’t structured for handy analysis by business analysts on the fly. So even if data lake technology is less costly than data warehousing, it may or may not be worth the investment.

For what it’s worth, I’d come down on the side of the data-lake boosters. Given the growing volume of heterogenous data being generated by healthcare organizations, it’s worth asking whether deploying a healthcare data lake makes sense. With a data lake in place, healthcare leaders can at least catalog and store large volumes of un-normalized data, and that’s probably a good thing. After all, it seems inevitable that we will have to wring value out of such data at some point.

E-Patient Update:  Registration Can Add Value To Care 

Posted on August 15, 2016 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

For those of you who end up seeking care in hospital emergency departments now and again, the following will probably be familiar. You’re spending the precious few minutes you get with the ED doc discussing your situation, having a test done or asking a nurse some rather personal questions, and a hapless man or woman shows up and inserts themselves into the moment. Why? Because they want to collect registration information.

While these clerks are typically pleasant enough, and their errand relatively brief, their interruption has consequences. In my case, their entry into the room has sometimes caused a nurse or doctor to lose their train of thought, or an explanation in progress was never finished. As if that weren’t irritating enough, the registration clerk – at least at my local community hospital – typically asks questions I’ve already answered previously, or asks me to sign forms I could easily have reviewed at an earlier stage in the process.

Not only that, there have been at least a couple of situations in which a nurse or doctor was so distracted by the clerk’s arrival that some reasonably important issues didn’t get handled. Don’t get me wrong, the skilled team at this facility recovered and addressed these issues before they could escalate, but there’s no guarantee that this will always happen, particularly if the patient isn’t used to keeping track of their care process.

Also, given that alarm fatigue is already leading to patient care mistakes and near-misses, it seems odd that this hospital would squeeze yet another distraction into its ED routine. At least the alarms are intended to serve as clinical decision support and avoid needless errors. Collecting my street address a second time doesn’t rise to that level of importance.

Of course, hospitals need the information the clerk collects, for a variety of legal and operational reasons. I have no problem signing a form giving it permission to bill my insurer, affirming that I don’t need disability accommodations or agreeing to a facility’s “no smoking on campus” policy. And I certainly want any provider that treats me to have full and accurate insurance information, as I obviously don’t want to be billed for the care myself!  But is it really necessary to interrupt a vital care process to accomplish this?

As I see it, verifying registration information could be done much more effectively if it took place at a different point in the sequence of care – at the moment when physicians decide whether to discharge or admit that patient.  After all, if the patient is well enough to answer questions and sign forms while lying in an ED bed, they’re likely to remain so through the admissions process, and verify their financial and personal information once they’re settled (or even while they’re waiting to be transported to their bed). Meanwhile, if the patient is being discharged, they could just as easily provide signatures and personal data as they prepare to leave.

But the above would simply make registration less intrusive. What about adding real value to the process, for both the hospital and the patient? Instead of having a clerk gather this information, why not provide the patient with a tablet which presents the needed information, allowing patients to enter or edit their personal details at leisure.

Then, as they digitally sign off on registration, it would be a great time to ask the patient a few details which help the facility understand the patient’s need for support and care coordination. Why not find out, before the patient is discharged, whether they have a primary care doctor or relevant specialist, whether they can afford their medications, whether they can get to post-discharge visits and the like? This improves results for the patient and ties in with a value-based focus on continuity of care.

These days, it’s not enough just to eliminate pointless workflow disruptions. Let’s leverage the amazing consumer IT platforms we have to make things better!