Making the Most of Electronic Health Records – It's All About Infrastructure

Electronic health records bring simplicity, ease and much needed information-sharing capabilities to the antiquated healthcare patient tracking system. Over the course of 2011, the healthcare industry saw the adoption of EHRs skyrocket with the incentives promised by meaningful use. Stemming from the Health Information Technology for Economic and Clinical Health Act of 2009, meaningful use regulations and incentives were put in place to ensure that healthcare providers implement EHR systems that meet both quality and efficiency standards designed to improve the delivery of patient care.

Digitizing medical records has the potential to significantly improve the quality of care for patients, but it is imperative that health organizations devote that same high level of care in implementing EHRs. Many of the challenges brought forth by EHRs commence from fundamental issues within their network infrastructure. Health organizations must bear in mind these challenges and responsibilities, in addition to recognizing what IT solutions can ease the transition and optimize the overall results.

Stage 1 of meaningful use requires that hospitals meet fourteen core objectives and eligible professionals meet fifteen core standards as well as five additional activities, in order to receive financial rewards and avoid penalties. Requirements include ensuring the privacy and security of EHRs by running a security risk analysis, generating and transmitting electronic prescriptions as well providing patients with their health information upon request — all of which require the appropriate technological measures to be in place.

EHR systems are designed with the goal of providing easy, centralized access to important medical information — but what good is that system if healthcare professionals constantly struggle to make different databases work together, and critical information is overlooked as a result? In healthcare, overlooking critical information can have serious repercussions, including misdiagnosis and improper treatment. And, the fact that many hospitals are currently transitioning to IDC-10, a new coding system that classifies diseases, just creates an additional hurdle. In implementing EHRs, totality of information is key, and can be addressed through new virtualization capabilities.

According to an Imprivita survey released in September 2011, the healthcare industry is expected to take the lead in the adoption of desktop virtualization, which is a great first step. However, desktop virtualization does not offer healthcare providers the totality of information necessary to provide the best possible care. Rather, hospitals should be looking into technologies that enable virtualization of the entire network, and furthermore, streamline communication with parties both inside and outside of the network. A completely virtualized network infrastructure at the machine level will enable all healthcare storage resources to appear as one resource, and all vital information will be readily available when providing emergency care.

Maintaining a successful EHR system is an ongoing process that requires continuous upkeep and strong attention to detail. It's critical that hospitals and health organizations have the IT infrastructure in place that will allow them to support the system long term. Once an entire network is virtualized, IT has complete insight into all network activity which will bring tremendous value to the organization. For example, network latency is a top concern regardless of industry, but healthcare in particular handles mission critical information round the clock. Physicians need to communicate with nurses and clinicians regarding medications, prescriptions now need to be transmitted electronically to pharmacies and hospitals must be able to exchange large image files without delay. X-rays, for example, are large files that need to be viewed in high resolution in order to make accurate diagnoses, and network latency could pose a significant hindrance in this situation. With the ability to view all network activity, including the flow of traffic, IT can ensure that these critical documents are not held up due to a network traffic jam.

As hospitals begin to enter Stage 2 of meaningful use over the next couple years, (initial requirements were announced at the HIMSS Conference in February, and are still being finalized), the exchange of medical data will become increasingly important. OpenFlow protocol and software defined networking technologies, which enable the direction and management of traffic flow among various routers and switches, will open the door for increased network flexibility and will even automate the control of traffic — guaranteeing that information is routed efficiently.

With virtualized networks and the ability to control traffic flow, secure interoperability between networks will become the driver in ensuring that patients reap the true benefits of EHRs. An interoperable healthcare system means that physicians will have access to all information necessary to treat patients as quickly as possible. This will empower them to immediately deliver appropriate care by ensuring that proper medication doses are administered, prescriptions are filled quickly and accurately, all critical documents are exchanged without delay and necessary follow up measures are taken because information is readily available.

Meaningful use legislation was specifically designed for healthcare, at its core it's not about innovation or IT, but about the improvement of patient care. Regardless, it's important to recognize that IT plays a tremendous role not only in the success of EHRs, but in reaping the full benefits EHRs can bring. EHRs are a small but critical part of a larger infrastructure that will enable health organizations to communicate medical information in a secure, timely and seamless manner. As the industry continues to move in this direction, the role of IT will evolve as well, posing new responsibilities to ensure that healthcare is operating as smoothly and efficiently as possible.

Eric Johnson is the CEO of ADARA Networks, a network virtualization company. He has been very involved in the implementation of electronic health record deployments in hospitals and health organizations across the United States and helping them to meet meaningful use standards.

More Articles on Electronic Health Records:

Study: Electronic Health Records May Inflate, Not Decrease, Healthcare Costs
CMS Announces March 12 Call on Stage 2 Meaningful Use



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