Effective sharing of patient information depends on getting different and often disparate systems to exchange data and, at the highest level, process those data.
This requires sturdy bridges between systems, interpretive and compatible algorithms, and integrated strategies for how different systems will be used and will work together.
THE BASICS OF INTEROPERABILITY
- Consolidating Healthcare IT Systems
- Securing Systems And Patient Data
- Developing An Enterprise Strategy
- Managing Human Factors
SOLUTION: Consolidating Healthcare IT Systems
The goal is to make the best use of IT, one that optimizes the delivery of effective patient care. When consolidating several PACS, for example, the most direct way is to offer a comprehensive radiology PACS that allows collaboration between the clinician and the radiologist who can view images at the same time. Ideally such a PACS would bring together data from multiple sources as in the case of several EMR systems, each of which may have created separate patient identities. The same goes for workflow, bringing together the different ways the different specialties work.
Consolidating PACS may involve the expansion of a system to take the place of others, for example, expanding a radiology PACS to takeover for the mini-PACS dedicated to pediatric cases (a legacy system tucked away under a radiologist's desk). Such expansion would require data migration, just as increasing efficiency to handle the increased data load may require upgrading the PACS.
So-called "single-stack" solutions are the easiest to deploy, for example, a single EMR system that handles the records of all patients in an enterprise, one that integrates data and function.
The opportunity to do so, however, seldom exists after healthcare systems consolidate. But there are ways to bring data together by implementing a centralized system.
In radiology the PACS provides the core diagnostic capability to radiologists. The Conserus platform extends this capability by adding tools that provide the ability to do a peer review of critical results, as well as to orchestrate and augment workflow. Conserus workflow orchestration tool is a rules-based engine that monitors and orchestrates different workflows throughout the enterprise.
Unifying data flow is Imaging Fellow, which connects data from multiple sources that may exist throughout the enterprise. It extracts specific bits of information, consolidates and aggregates them; then presents them to the radiologist in a way that is easy to understand and use.
SOLUTION: Protecting Systems And Patient Data
Cyberattacks threaten the provider-patient relationship by eroding patient trust. They also expose providers to lost revenues and penalties under HIPAA rules that require the protection of patient data.
Simplifying the IT landscape can help secure data. As the number of interfaces goes up, so does risk. This is because each interface provides a potential target for hackers. This is especially so for legacy systems that have obsolete security measures.
But it is more than just a target rich environment that makes healthcare providers with a lot of disparate systems vulnerable. Interfaces break; they become asynchronous -- much to the delight of hackers.
When dysfunction occurs, risk can still be minimized by controlling the flow of patient data. The more information transmitted from one information technology to another, the greater the chance that a hacker will gain access to patient information that can be sold on the black market.
By selectively extracting data from other IT systems and presenting just those bits of information, Imaging Fellow reduces vulnerability.
Access to patient data may be critical to the proper management of care. And there are times when, for one reason or another, a caregiver who needs that access may not have it. Vendors typically offer "break-the-glass" functionality in such cases. But that functionality should be the very rare exception to the rules that govern access to patient data. And it should provide very selective information about the patient.
SOLUTION: Developing An Enterprise Strategy
Coming up with an IT strategy -- whether that involves a single-stack solution or the integration of multiple systems -- requires input from all stakeholders. Problems are not always obvious. But they must be found before an effective strategy can be developed.
When developing a strategy, the means for measuring problems -- and success in overcoming them -- must be determined. The strategy is to draw a roadmap that identifies the tools that must be applied; where they should be applied; and when. When coming up with an enterprise imaging strategy, it is important to connect the imaging goals of the enterprise with those of the stakeholders in the enterprise.
Nowhere is this more obvious than in cardiology, which must deal with problems such as "dual charting," which occurs when an inpatient undergoes tests in the outpatient arena.
In a healthcare system comprised of many departments spread over several campuses and dependent on multiple disparate information technologies, processes must be developed for handling differences that come from the use of these systems. One critical example is the handling of patient identifiers. When strategizing, ask whether the new approach will have the means to retain all the patient identifiers or must all those records be updated? Keep in mind that the need to manage multiple patient identifications will increase as patients become more mobile and travel between different care settings, a possibility made increasingly likely as medicine moves away from fee-based value-based practice.