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The Result: Care Coordination and Improved Outcomes

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Where is all of this technology headed? While some ECPs may view the installation of EHR systems as a means to the end of receiving incentive payments for their documented meaningful use of certified software, this is actually only the beginning. The incentives were put in place to encourage doctors and hospitals to install the software that will be necessary to share encrypted information over secure health information exchanges, which in turn will enable all practitioners on a care team to have access to the necessary health records related to a particular patient.


 

  Computing in the cloud enables you to access your data from anywhere at anytime. Photo courtesy of RevolutionEHR.
“Interoperability is the core foundation of where the government sees health care going,” said Steve Baker of Eyefinity. “It will allow the medical professionals around the patient to seamlessly share information for their health and wellness, to keep them out of the emergency room and away from the debilitating diseases that are causing the country to go broke. What optometry brings is probably the most valuable piece, the ability to diagnose far earlier in the process.”

Stage 2 Meaningful Use standards, which will go into effect in 2014, require connectivity among all care providers and with patients themselves. This will be achieved by electronically transmitting patient health records (PHRs) and continuity of care documents (CCDs) via the internet through health information exchanges (HIE).

“Health information exchanges are currently being created at the state level,” said Jens of software company RevolutionEHR. “The value of HIEs is that they create a center hub for data that is currently often estimated by the medical practice, and they keep the patient from having to self-report. We’re only six months away from using true health information exchanges. In 2014, those providers who move toward Stage 2 Meaningful Use will have to move toward HIEs to exchange health data in real time.” For example, one of the requirements of Meaningful Use Stage 2 is that 5 percent of an ECP’s patients will have to be able to send their practitioner a secure encrypted message through a portal. “The big change for EHRs is that they’re not just a data repository but will have to bring more patient engagement,” said Jens. “It’s not so much that I have to send a patient a message, it’s whether they send me a secure message.”

“If you have connection to Direct, you will meet all the national requirements of data exchange,” he added. ONC Direct is an approved encrypted transmission protocol that Health Information Service Providers, or HISPs, must use. More information is available at www.Directproject.org.

Personal Health Records

In addition to health information exchanges, patients will be able to participate in the maintenance of their own personal health records, information that they can then securely share with their care team and insurance providers. One example is Blue Button being used by several federal agencies, including the Departments of Defense, Health and Human Services, and Veterans Affairs. In 2010, the Center for Medicare and Medicaid Services (CMS) launched its version of Blue Button, providing online access to 40 million beneficiaries. Today, the use of Blue Button has expanded to private sector organizations, including health insurance companies and EHR developers. Blue Button provides patients with an easy way to retrieve and keep track of their health while offering practitioners an easy way to share data with patients.

Microsoft’s HealthVault is another example of an online health record repository for easy accessibility and sharing. It lets patients store health information from many sources, access a range of health and fitness apps, upload data from health and fitness devices, and share health information with those they trust. Among the ways it can help ECPs achieve Meaningful Use requirements is by being integrated into their EHR to electronically upload a continuity of care document (CCD). Encrypted information can be send via Direct Project messaging.

These and other systems for storing and sharing patient health records will assist ECPs with meeting the secure electronic communication criteria required by Meaningful Use Stage 2.

Statistical Analysis

Combining all of the data stored by these software programs will result in other benefits. Its use for benchmarking and statistical analysis is already taking place. The American Academy of Ophthalmology, for example, has announced plans for an EHR-linked eye disease database that will enable ophthalmologists nationwide to statistically analyze and benchmark their own care. The Intelligent Research in Sight Registry will gather data from electronic health records and perform statistical analysis on the aggregated patient data to produce benchmark reports on both the national and practice levels. The AAO estimates that the IRIS Registry will have more than 20 million patient records within two years.

Ultimately, with the ability to access patients’ records, both in aggregate as well as on an individual basis, at anytime from anywhere, eyecare professionals will ultimately achieve one of the primary goals of health care reform—improved patient outcomes—and electronic health records will be the foundation on which that and a major transition in health care will be built. ■

 

Recent Developments Launch a New Generation in EHR

The prevalence of EHR in the optical field is illustrated by a number of major developments, some recently introduced at AOA Optometry’s Meeting in San Diego at the end of June. Two prominent companies in the eye-care field launched two new next generation electronic health record software programs.

VSP’s Eyefinity division introduced Eyefinity EHR in conjunction with software developer Modernizing Medicine. The cloud-based native iPad program features an intuitive user interface and adaptive learning that adjusts to diagnosis style and eliminates the need for templates.

VisionWeb launched Uprise, a new electronic health records program built from the ground up by optometrists for optometrists. Designed to be friendly on both tablet and PC devices, the cloud-based system was developed in partnership with VitalHealth software to meet the specialized needs of optometric practitioners. Uprise will feature embedded educational video content from ECHO by Eyemaginations, product catalogs with wholesale pricing information from Frames Data, and CPT and code process and rule verification by CodeSAFE from ReimbursementPLUS, making them native to the system.

Also introduced at the AOA meeting in June, RevolutionEHR’s MyRev mobile app enables ECP users to check their patient schedules and access patient information right from their smartphones.

AOAExcel, the wholly owned subsidiary of the American Optometric Assocation, launched OcuHub powered by AT&T as part of its Healthcare Community Online program. This new health information exchange designed specifically for optometrists by the national optometric association was created to enable ECPs to connect electronically to physicians, hospitals and their ancillaries, pharmacies, payers, benefit managers, optical labs, medical labs, imaging and radiology services, employer human resource departments, home care providers, and with patients themselves. Through the use of EHRs, ECPs will be better connected than ever before.

“It will effectively ensure that optometrists who wish to meet Stage 2 standards and thereby qualify for federal incentive bonuses will be able to have the required connectivity,” said Joe Ellis, OD, AOA Excel chair and past president of the AOA.

Many other apps, integrated technologies, software updates, and more are introduced regularly, continually upgrading the technologies associated with electronic health records.