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3A's (Aggregate, Analyze and Act) of Healthcare IT

3A's (Aggregate, Analyze and Act) of Healthcare IT
19 September 2019

AAA, is not just an acronym for the American Automobile Association anymore. It now also stands for blueEHR’s philosophy about population health, improved patient outcomes, and better value-based billing. AAA: Aggregate, Analyze, and Act. blueEHR will aggregate all of the data in one place, analyze it with custom dashboards and reports, and will give practices the ability to act on that with as little as one click.

Why are more and more healthcare actors from hospitals, accountable care organizations, all the way to electronic health records (EHRs) focusing on population health? Since 2010, when the Affordable Care Act was enacted it has set out to do just that. By focusing on improving how healthcare is delivered in the United States, especially to some of its most vulnerable populations, while reducing the cost of that care, it has pushed American medicine on to new courses of treatment.((Affordable Care Act (ACA) Glossary.”)) This shift from traditionally focusing on caring for individual persons to conceptualizing populations has required the entire healthcare community to redesign the framework of how care is thought of and provided from medical school and clinical care to research enterprise and your EHR.((Gourevitch, Marc N. “Population Health and the Academic Medical Center: the Time Is Right.Academic Medicine : Journal of the Association of American Medical Colleges, Published for the Association of American Medical Colleges by Lippincott Williams & Wilkins, Apr. 2014)) These systematic changes, coupled with the push towards the application of precision medicine in a population health setting requires a flexible, and malleable health system to aggregate and analyze patient data which can then be acted upon.((Glasgow, Russell E, et al. “Realizing the Full Potential of Precision Health: The Need to Include Patient-Reported Health Behavior, Mental Health, Social Determinants, and Patient Preferences Data.Journal of Clinical and Translational Science, Cambridge University Press, June 2018))

The common saying that an individual’s health is more likely to be determined by their zip code than their genetic code has a lot of truth behind it, especially for the most commonly occurring chronic illnesses. The science behind determining the prevalence of recurrent conditions indicate that environmental factors, such as those addressed by the social determinants of health (SDoH) and individuals’ behaviors are creating powerful comorbidities for many illness. Recognition of the environmental factors that affect health, as well as genomic, biomarker, diagnostic, and pharmacy data are setting in motion the opportunity for interventions to reduce healthcare disparities in different populations; regardless of how they are defined. The methodology of precision health in tandem with population health will only be realized when a health IT system can pull this complex data and then analyze it in a way to be useful to a provider or organization from the emergency department (ED) all the way down to a volunteer provider at a free clinic. Lastly, the analytics are only useful if there are quick, practical, and efficient ways to act on that data either by supporting provider decision making or by working with the patient to be a partner in managing their own healthcare. blueEHR’s AAA has great potential to support drastic changes in your patients’ health outcomes.

Examples in the use of technology’s tremendous potential for improving the quality of a person’s healthcare outcomes can vary from applying a high-risk queue management theory at an ED to reducing medication interactions or treatment mismanagement by integrating a health information exchange (HIE) with a private practice’s EHR. Using an EHR or other informatics system to leverage the vast array of data on a patient population from SDoH, to genomics, to ongoing treatment plans offers new tools for determining recent trends appearing in populations and are helping to create and tailor custom, effective treatments for micro-groups. In a real life example from our partners at Unisys; they were helping an east coast based hospital chain to reduce the number of ED readmissions with-in 30 days of initial discharge. Initially looking at just one condition, chronic heart failure, and over 150 points of data they were able to identify several patient trends that had patients readmitted within a month that was costing the hospital several million dollars underneath the value-based care payment system. By collecting the data, having a system analyze, and then act upon that data it allowed the hospital to recoup over 12 million dollars in a single year from a single condition. As these payment model systems are becoming more and more popular, it requires practices of all sizes to have a robust framework to address the vast wealth of information at a provider’s fingertips.

As patient health data becomes more complex and continues to expand in scope there are some things to consider when looking for an EHR.

The first is; are you purchasing an EMR or an EHR? An EHR is an electronic health record. This means that the functionality of the program has more capabilities than just a static medical record. Many EMRs are just that, a record. They are a former paper chart, now on a computer screen. A true EHR will have the ability to AAA your patient data in multiple different ways to meet the changing needs of your practice and population. An EHR will be able to support provider decision making, patient outreach and accountability as well as integrate with other systems and HIEs to create a complete patient profile.

[Read MoreWhat sis the difference between EHR and EMR]

Once you have found an EHR that has the capabilities you need it is important to address AAA. As an example, blueEHR has API, HL7, and soon, Fire HL7 integration capabilities. We can connect with HIEs, other EMRs, and various health based technologies. This means that blueEHR can aggregate the data not just from what is collected within our product but also from local hospitals and the state creating a full picture for the provider. blueEHR is built as modules within an ecosystem or platform and not as a monolithic program. It has the flexibility to connect all the data that is gathered in one place, including data that might not be required or collected now but will be in the future. The advantage of having a platform product is the ability for quick change and updates as new best practices or trends develop. Rather than rewriting thousands of lines of code to make a new data point, only the relevant module is updated. New changes and capabilities are pushed out monthly in blueEHR. For some of the traditional monolithic products it can take over two years. With blueEHR you are always up to date with cutting edge health-data trends.

When evaluating the right product for you, the second consideration should address how the EHR analyzes the data.

What does your EHR provide?

  • Can all of the data, even free text, be made reportable and quantifiable? blueEHR can.
  • Can you write your own reports? By the end of the year, blueEHR can.
  • Can you have custom visual dashboards to quickly identify the population health indicators, then be able to drill down into the graphs and charts for the raw data? blueEHR can.
  • Do you want to take industry standard indicators from NIH, CMS, HRSA, among others, and be able to have the system search for appropriate patients and auto-enroll them into a cohort? blueEHR can.
  • Do you want you use MicrosoftDB, Oracle, or other analytics programs? blueEHR gives you a copy of your mySQL database that can be downloaded regularly according to your predetermined preference and have it always available. Your data belongs to you.

blueEHR can meet these needs and more.

Lastly, when considering different EMRs and EHRs available it is important to consider, once you have the data, how do you utilize it to benefit your patients and your practice? If you are going to use your data to affect a population how do you do that without adding an undue burden on your staff or providers? This is where blueEHR comes in. We want you to take the data you have gathered and be able to act on it. With integrated emails and SMS messages, pushing out reminders to patients to follow up on their care, track their blood sugars, or get standing labs done is as simple as writing a rule to create automations or pushing a button on a case by case basis. Want to be able to identify in an encounter to your providers that this is an at risk client and recommend more treatments? That can be written as a rule to pop up once several indicators are met. blueEHR can give you the tools required to act on the data you have gathered enabling better patient care and better health outcomes. Want to have a system that can identify patient complexity and balance provider panels for greater efficiency and patient treatment? blueEHR can give you this level of oversight and management. These are just a few examples of what blueEHR can do for you.

Precision medicine and population health are changing the landscape of what quality care looks like. Be ahead of the curve and make sure your preferred EMR or EHR product meets the needs of providing healthcare today, tomorrow, a year and five years from now.