While healthcare organizations have come a long way in adopting technology to bolster care, there are still miles to go as far as implementation is concerned. This is the takeaway from the CHIME “HealthCare's Most Wired: National Trends 2018” report, released at the CHIME Fall Forum in San Diego on Oct. 31. The yearly report, which was previously overseen by another organization before being taken on by CHIME this year, seeks to honor the organizations that are excelling when it comes to health IT adoption and deployment as well as to better understand the technology landscape.
Five areas for improvement came to light in the report:
1. Security Has Come Far for Healthcare, but Not Far Enough
Any CIO will tell you that security is the top priority for healthcare IT leaders, rising in prominence as both internal and external cyberthreats grow.
“Security is still developing in healthcare, and few organizations have a comprehensive program in place,” the report notes. In fact, only 29 percent of organizations have a comprehensive program in place — or one that includes “dedicating a senior security leader, having an adequate security budget, establishing governance and oversight committees, and meeting regularly to report gaps in security and progress toward closing them,” the report defines.
Progress has been made, however, particularly as it pertains to adopting trusted cybersecurity frameworks, with 78 percent of organizations reporting that they have adopted the National Institute of Standards and Technology security framework and 40 percent reporting that they have adopted the HITRUST framework.
There is still progress to be made, however, as nearly 20 percent of organizations still use self-developed security guidelines and, further, only about one third of healthcare organization boards meet regularly to discuss cybersecurity.
“Security should be table stakes now, everybody should be doing all the right things. But, of course, we know it’s hard, people are challenged with it every day,” said Drex DeFord, a member of the Most Wired Governing Board at the conference. “It is a very foundational thing that separates the most wired from the rest of the pack.”
2. Interoperability Needs a Boost to Support Value-Based Care
The healthcare technology ecosystem is, without a doubt, becoming more complex as technologies like electronic health records, the Internet of Medical Things and more enter the picture. While all these technologies might generate more data than ever before, the number of fragmented systems with poor communication between them means that clinicians can’t access all the necessary information to truly improve patient care, particularly as the system seeks to transition to value-based care, the report notes.
“Beyond improving patient care, interoperability can also help provider organizations achieve outcomes like increased operational and workflow efficiencies,” the report states. “By investing in robust infrastructures that can support and facilitate communication in the complex healthcare environment, organizations can make better data-driven decisions and achieve greater outcomes.”
Progress looks good, as 94 percent of organizations have adopted integrated clinical application suites and 86 percent have adopted remote published applications. But when it comes to better sharing data, “there’s still some work to do,” DeFord notes.
3. Patient Engagement Tools Need a More Clinical Mindset
Many organizations have adopted tools and infrastructures that are designed to improve patient engagement satisfaction. In fact, an overwhelming majority (81 percent) have adopted solutions like entertainment options or mobile applications that make it easy for patients to engage with care. The next step, however, needs to be in adopting tools for clinical use, including adopting tools that facilitate real-time engagement monitoring, inviting patients to participate in the discharge planning process and making more use of mobile tools for hospital wayfinding or to communicate wait times.
“Everybody’s got entertainment, we like to watch TV, surf the net and answer satisfaction surveys. We’re really just starting to use it for the logistical functions that will bring value to the logistical care process,” said Bill Spooner, chair of the Most Wired Governing Board. “Communicating with my provider, putting in dietary orders, telling housekeeping to turn up or turn down the heat, things like that, to be able to better facilitate the care process.”
4. Population Health Tools Are Still Fragmented
There has been much progress for population health use, particularly when it comes to using billing data. Already, 57 percent of healthcare organizations are using clinical and billing data as well as a health information exchange to identify gaps in care.
But in order to take population health to the next level, to deliver the data necessary to providers in the field to enhance care and support value-based care, the tools themselves need to mature and become less fragmented.
“The tools are still incomplete,” said Spooner. “If you want to continue to see progress over the years — we probably have about 50 companies playing in this space — as we move forward, we need to reduce the overhead that’s attached to that. Right now, it’s taking us a lot of effort to pull all this data together.”
The need for more comprehensive solutions will continue to grow in importance as more patients are pulled into population health programs and value-based care continues to evolve.
So, where should organizations start? The report suggests that healthcare IT teams and leaders first focus on foundational IT before they branch out to newer capabilities.
"Before provider organizations can achieve outcomes with their strategies for population health management, value-based care, patient engagement, and telehealth, they must first ensure that foundational pieces such as integration, interoperability, security, and disaster recovery are in place," the CHIME report concludes.