Community Record of Care for Accountable Communities of Health

June 02, 2016

EHR Diversity making a comeback

Written by Duncan West

EHR Diversity is here to stay

Several recent events emphasized the worth of Health Information Exchanges in knitting together a care community, regardless of the Electronic Health Record (EHR) vendor selected by the community’s providers.

· The Centers for Medicare & Medicaid Services (CMS) recently recognized that rewarding Eligible Medical Professionals for connecting to each other missed multiple, very important connections within the care community. The additional providers include Skilled Nursing Facilities, Physical Therapists, Hospice, and more. CMS issued letter SMD# 16-03 which offers state Medicaid authorities a 90% match of the cost for initial integration of these additional provider categories.
Recognizing the need to support the full range of care givers, MIN-NS has had great success connecting local SNFs, Home Health, Hospice, Physical Therapy, and even jails our HIE .
We hope that the Health Care Authority (HCA) in Washington State joins the CMS program and uses their funds to extend the reach of electronically connected care.

· The HCA has applied to CMS for an 1115 Waiver. In a previous blog on the program, I mentioned MIN-NS’ proposals for coordinating transitions of care in and out of jail, and for connecting social and human services providers with medical providers.
The social and human services agencies do not have EHRs. However they play a vital role in care coordination and patient health by tackling aspects of care plans which deal with transportation, housing, food, access to medical equipment and provisioning of chore services.
MIN-NS has had great success connecting local Area Agencies on Aging to the medical community. We manage a registry of Medicare – Medicaid patients who are under active care management, alerting the AAA when one of the patients is in the hospital.

· A recent Black Book survey of specialist surgical and medical practices found a trend toward EHRs which support templates and workflows best suited to most common diagnoses treated by any specialty. The survey, conducted in the first two quarters of 2016 among over 11 thousand providers found that 29% of the specialist providers had changed EHRs from their initial implementation. Configurability and support for workflow within EHRs has raised the level of satisfaction. Providers who feel their EHR meets or exceeds expectations rose from 13% in 2010 to 84% in 2016.
Selecting and customizing their EHR has led to concerns among 88% of the specialists that their preferred EHRs do not fit well with hospital or regional EHRs.
In our region and elsewhere in the state we see physician groups who are key to the care of the community committed to an EHR which supports their workflow and in which they have invested. It is the role of the MIN-NS HIE to knit together the EHRs of choice, the EHRs which make providers most efficient, into a community of care with access to a longitudinal record of care.
Among the 44 specialties surveyed, some of the top EHRs are well known. Below is a list of EHRs which the survey showed were most used in 3 or more specialties. Three other EHRs were tops in 2 or more specialties: