1. Hospitals lead docs, patients in health information exchange
Hospitals are increasingly exchanging clinical data (lab test results, radiology reports, clinical-care summaries, and medication lists) with providers outside their organizations. Hospitals are far ahead of office-based physicians, who are well ahead of their patients, according to multiple surveys presented by the Office of the National Coordinator for Health Information Technology when it comes to the electronic exchange of health information. The percentage of nongovernment hospitals that electronically exchanged clinical data this increased from 41% in 2008 to 62% in 2013.
However when it comes to physicians, just 39% of them exchanged information with other providers in 2013, and only 14% performed those exchanges with providers outside of their organizations. Only 5% exchanged information with outside hospitals.
Vaishali Patel, a senior adviser to the ONC’s Office of Planning, Evaluation and Analysis says the purpose of the multiple survey work was to monitor the progress of exchange as the federal electronic health-record incentive-payment program under the American Recovery and Reinvestment Act shifts gears from the Stage 1 meaningful use criteria to Stage 2.
Patel says “To date, most of our measurement activities have focused on health information exchange as opposed to interoperability,” which she says differentiated as not just the swapping of information, but “the ability of EHRs to digest the information and parse it out and be able to use it for other purposes.”.
In another survey by the National Center for Health Statistics, 80% of physicians agreed that provider-to-provider health information exchange increases practice efficiency though problematically, 64% said it required multiple systems or portals to do that.
Most commonly, 36% of physicians report exchanging lab information, but about a third of physicians also reported exchanging medication lists, medical allergy lists, problem lists and imaging reports. There was far more variation in the types of information exchanged by hospitals,
- Labs top the list in the 2013 survey at 57%
- Radiology reports, 55%
- Clinical care summaries, 42%
- Medication histories, 37%.
In each category, the number of hospitals performing these types of exchanges increased by 12 to 18 percentage points since 2008.
Patients, too, are starting to take advantage of data sharing tools. In an ONC telephone survey of consumers in 2013, 28% of adult patients reported they’d been offered online access to their medical records. Of those with online access to their records:
- 46% viewed their records online
- 44% shared their information with another healthcare provider or family member
- 39% downloaded their records
- 11% sent their data to a mobile application or a personal health record.
Source: Modern Healthcare, 8/6/14
2. Patient-Centered Medical Homes Reduce Costs
Patient Centered Medical Home programs continue to show benefits for patients and providers. The patient-centered medical home (PCMH), introduced in 2007, a model of health care that emphasizes personal relationships, team delivery of care, coordination across specialties and care settings, quality and safety improvement, and open access. A new report in the journal Health Services Research finds the model offers a promising option to reduce healthcare costs and utilization of some health care services as the number of PCMHs has increased.
The new study shows Medicare expenditures among PCMH patients growing more slowly compared to Medicare patients not in PCMHs – the primary drivers appear to be that ER visits and acute care hospitalization costs are lower for PCMH program participants.
· Martijn van Hasselt, Ph.D., of the nonprofit RTI International in Research Triangle Park, N.C. says “the total Medicare expenditure side actually grew at a slower rate for patients who received care from a medical home versus not. Costs also seemed to be lower for acute care hospitalizations when patients had received care from a medical home, and the number of E.R. visits also declined relative to the comparison group of patients.”
· Sarah Scholle, DrPH, NCQA’s vice president of research and analysis says “an ongoing debate exists about the impact of the patient-centered medical homes on costs of care. She states “this study adds to the evidence suggesting that patient-centered medical homes can reduce costs of care, but how do they achieve savings? There isn’t a single clear answer.” The study also points to reduced emergency department visits and more effective management of sicker patients, as do other studies, she said.
Source: Center for Advancing Health, 7/31/14
Graphic of the Week: Care Teams Help Fill Gaps in Care
Source: Health Intelligence Network