There is a seismic shift happening in the healthcare industry, creating business needs and opportunities for non-EHR systems to integrate with EHRs. It’s a now or never moment that non-EHR ISVs cannot afford to miss if they have to remain competitive in the marketplace. Let’s look at these industry-changing trends and how they will impact the integration scenario.
A Shift Towards Value-based Care
Transition to value-based care is accelerating purchase of non-EHR systems by providers. 38% of providers are expected to invest in non-EHR technologies in the next three years as per a PwC report. Although EHR is considered as a strategic asset, providers are looking to other technologies to address the limitations of EHRs; to improve health outcomes, to lower cost of healthcare delivery, and meet consumer expectations, all of which happen to be prerequisites for value-based care.
Some of the non-EHR platforms that help transition to value-based care include platforms for Population Health Management (PHM), Clinical Communication and Collaboration, Patient Engagement and Telehealth. However, to unlock full value of investments, these non-EHR systems need to interact with EHRs.
Select use cases that highlight the need for integrating non-EHR systems with EHRs to promote value-based care include:
- Integrating PHM platform with EHR to enable “harmonious meshing” with providers’ workflows to identify care gaps and to add the PHM care plans into the provider’s EHR workflows. On the other side of the spectrum, PHM platforms can identify new care gaps or close the ones that are already acted upon, using real-time data from the EHR.
- Integrating Clinical Communication and Collaboration Platform with EHR will enable sending STAT orders and their results directly from the EHR to the right person and in real-time.
- Integrating Patient Engagement Platform with EHR will enable timely reminders and alerts to the patients on medication adherence, and thus help reduce readmission and create a cohesive experience for the patients.
New Telehealth Laws and Regulations
Changes in telehealth reimbursement laws combined with new Acts such as CHRONIC Care Act of 2017 have incentivized providers to increase use of telehealth platforms. According to a study released by KLAS Research and CHIME, almost 60 percent of healthcare provider organizations with telehealth programs plan to expand the number of service lines or specialties served through the telehealth systems. However, promises of integration from telehealth vendors have not been realized. Even when integration is achieved by providers, it is most often unidirectional.
Some of the business drivers for integrating telehealth platform with EHR include:
- Improve physician’s productivity: A bidirectional integration would enable physicians to work within a single platform and eliminate duplication of efforts such as documenting clinician’s note from a telehealth encounter into the EHR.
- Reduce administrative overheads: With more telehealth visits becoming eligible for insurance reimbursements, the need for patient eligibility verification, claim submission, diagnosis and procedure coding on the telehealth platform will arise. Providers will most definitely prefer reuse of their current infrastructure, as against investing in telehealth platforms that build parallel, redundant features.
- Improve quality of care: Access to charts, orders, drug-drug checks and the entire decision support systems that were available at the provider’s fingertips and so vital to their decision making will be needed during the time of a telehealth encounter as well.
Personalized Medicine
Precision medicine and genomics are innovations beginning to find their way into the mainstream of healthcare. It is estimated that more than $5 billion is currently spent on genetic and genomic testing in the United States, and this is projected to increase to $25 billion by 2021.
Electronic Health Records have an important role to play in the practice of precision medicine. The ability to identify the need for a genetic test at the point of care and adding the test results into the clinicians’ workflow will aid in better diagnosis, recommending additional investigations, and thus promote optimal care for the patients.
- For example, pharmacogenetics tests may be used to help identify genetic variations that can influence a person’s response to medicines. While the EHRs cannot store whole exome sequences, a query to genomic server along with the clinical data can provide decision support for physicians.
Mergers and Acquisitions
Merger and Acquisition (M&A) activities are becoming a dominant force shaping the healthcare industry today. Most of the time, hospital M&A is sold as an exercise to save money by reducing overhead and leveraging shared strengths. For ISVs, after all the hard work that goes into building a happy customer, the last thing one needs is losing out a well performing account to an M&A activity.
The merged entities typically are invested in multiple EHR and non-EHR technologies. While many non-EHR platforms may claim to survive on their own, typically we see the ‘survival of the integrated!’
Two recent examples are:
- HealthAsyst’s solution for improving the radiology workflow, RadAsyst, was well integrated with a best of breed radiology product. A key user of RadAsyst was a large health system which was in fact the beta site for RadAsyst. A lot of time and effort was invested in building custom workflows for this health system in an effort to have an extremely satisfied customer. Unfortunately, at the time when the health system decided to move to EPIC, neither was RadAsyst integrated with EPIC nor was EPIC open enough to accommodate all the complex integration requirements. This meant, lost business due to M&A in spite of heavy investments and a happy customer!
- One of our customers for EHR integration services – a leading document management and indexing system vendor- had a similar experience. Fortunately, we had shared our above experience with them, and they decided to have an EPIC integration strategy in place. When one of their large customer decided to switch over from GE to EPIC, they were in a position to demonstrate the required integration with EPIC and thereby able to retain their customer.
21st Century Cures Act
There are not many issues that members of the Congress agree on, but the passage of the 21st Century Cures Act late in 2016 proved that supporting health care innovations has strong bi-partisan support. Apart from all the other provisions, the Act further weaves interoperability standard into the EHR certification process by stating that the EHR certifications made on or after January 1, 2018, must certify that the technology is interoperable as defined by the standard for interoperability in the Act. Beginning January 1, 2019, products that are unable to meet the interoperability standard detailed in the law will lose their certification.
This was a defining moment because unlike HITECH and Meaningful Use, the act now mandates EHR vendors to move towards integration and interoperability and encourage non-EHR technology vendors to integrate with EHR.
Conclusion
The business trends, as well as regulations in the healthcare industry, are sending out clear messages to non-EHR software vendors on what their future looks like. Integration with EHRs is no longer good to have, but a strategy for survival for non-EHR ISVs. Organizations who act first and fast, and have an EHR integration strategy in place, will have the biggest opportunities in the market as well as a sustainable competitive advantage.
What is your EHR integration strategy? I would love to hear from you. Write to me at bhupesh.nadkarni@healthasyst.com
