Next Generation Technology Implementation for Small Medical Providers

Recent years have seen the patient to small medical provider relationship remain largely unchanged despite advancements in cloud (remote) hosting security and health information technology.  Current HTML web based forms and low security online payment systems fail to provide the level of interactivity that patient’s desire. Additionally, small providers still rely on costly in-house IT, creating a burden for the office and staff. These technologies, once viewed as a “must have” are now the barriers to evolving the patient-to-provider relationship.

Consumers access online banking from their smart phones, read books from their tablet PC library, and shop for groceries at an online store. The shared characteristic between these actions, disregarding their simplicity and accessibility, is the presence of a secure portal to access and interact with technology. The portal allows for personalization of data, which creates a bond between the product and the consumer. 

The patient portal technology has been adopted with great success by most of the large local and regional medical providers. Patients can interact online to schedule appointments, transfer messages, view lab results, view their personal health record and complete copayments. The powerful aspect of the portal becomes apparent when it is integrated with a HL7 standardized electronic health record, such as the open source OpenEMR, allowing for worldwide transferability of patient information between providers. 

The widespread availability of high speed internet has paved the way for health IT vendors offering low cost cloud based on demand software. Small healthcare providers previously priced out of the patient portal and EHR market can now implement these remotely hosted technologies for less than $10,000. 

Serigne Ndiaye, CTO of AcuMedSoft LLC, a provider of HIPAA compliant cloud hosting and acuPortal, a web based patient portal, believes that the Medicare EHR Stimulus Program will provide motivation for small medical providers to update their technology systems. Ndiaye says “Eligibility for the $44,000 in individual physician grants for demonstrating meaningful use of an electronic health record requires a patient portal to exchange specific information with patients. If a small provider upgrades their system in 2011, and fully participates in the program until 2015 and receives the full grant, they basically receive a free upgrade to next generation technology.”

The problem is that many of the small medical providers have not had the time to evaluate value derived from the patient portal and have viewed it as a luxury that only large providers can afford. These assumptions are no longer valid, and it is time for patients to demand from their physician access to a patient portal.

EHR Quality Improvement

Electronic Health Record Adoption and Quality Improvement in US Hospitals

This report analyzes approximately 2000 US hospitals with varying levels of EHR capability in an attempt to determine the quality improvements derived from "use" of EHRs. While the conclusion is discouraging -- EHR implementation has limited effects on quality improvements in hospitals -- it is important to analyze the documented limitations of the study to determine a future solution to improving the results.

Limitation 1: EHR implementation has different effects on quality improvement for conditions other than the 3 studied.

This limitation is a barrier to developing standards for measuring the effects of EHR quality improvement because of the amount of clinical data needed. Developing condition specific metrics is crucial to fully evaluate the quality improvement of EHR.

Limitation 2: Approach to measuring EHR capability did not account for the adequacy and frequency of EHR use or variation of EHR functionality between hospitals.

The report makes note that "Moving forward, metrics of meaningful use of an EHR should make it possible to better assess and identify which elements of EHR use have the greatest effect on clinical quality." This will be possible when more data becomes available, which will only occur when standards exist for measuring EHR quality improvement. Once standards are in place, it will be easier to identify the performing and lagging metrics.

The report lays solid framework for developing nationwide standards for measuring the effects of EHR use. The Office of the National Coordinator for Health Information Technology is responsible for delivering an effective standardized method and has the help of IT vendors and the health care community in doing so. The challenge will be to sync these standards with current vendor offerings while adapting future standards to technology changes.