HIEs Experience Growing Pains, EHRs Stumble with Population Health

May at Chilmark Research saw us compiling the results of extensive research for two major market reports one on Health Information Exchange (HIE) and the other on Analytics for Population Health Management. Both will be released shortly. In our May update, we preview the HIE report and also look at what it will take for electronic health records (EHRs) to truly support population health management. You can read abstracts of each below.

Subscribers to the Chilmark Advisory Service (CAS) receive among other services, research content that includes: Monthly Updates, quarterly Insight Reports, and one major Market Trends report a year as part of their membership. To find out how you can receive the full update, send an email to: info@chilmarkresearch.com.

HIE Market in Transition, Requires New Vocabulary
John Moore

The HIE market has always had trouble defining itself. In the early days, vendor marketing messages painted a rosy picture of what an HIE could do, but when one pulled back the curtains, few products on the market could actually exchange health information across a heterogeneous EHR environment. Fast forward to 2013 and the market is redefining itself once again and vendor messages have become more vague.

In the HIE of the future, HIEs will be the interstitial layer that connects all the various IT systems across a community to present patient data in a coherent manner in support of collaborative care processes. Unfortunately, the nascent state of interoperability still makes actual execution a challenge. The industry is moving in the right direction, but it is a slow and often expensive move.

In this month’s update and the upcoming 2013 HIE Market Report, we define a future state for health information exchange: HIE 2.0. Frankly, we are not fans of the trendy 2.0 language, though it comes in handy to describe a technology in transition. In our report and over the coming year, Chilmark Research will begin defining a new HIE vocabulary, one with more staying power and specificity that incorporates the important challenges ahead for this critical infrastructure technology.

Building Towards Population Health Management
Rob Tholemeier and John Moore

Core to any technology platform that supports population health management (PHM) is the ability to effectively and accurately capture, store, and allow for ready retrieval of a patient’s health history and current condition. Today, healthcare providers of all sizes are looking to EHRs to accomplish much of this task. We doubt that today’s crop of EHRs are up to the challenge.

Early EHRs were not designed first and foremost to facilitate and improve the delivery of care; they were designed to facilitate billing. The focus on billing led to the creation of solutions that have zapped physician productivity and generated widespread reports of physician productivity dropping 25-30% during the first year of go-live.

The next generation of EHRs will require significant enhancements to support provider effectiveness and efficiency in the delivery of care within a PHM construct. In this research note, we look at four of the necessary enhancements: embedded analytics; intelligent rules engines; situational awareness; and standardized interfaces. A future research note will examine three more: human-centered design; natural language processing; and biometric and patient-generated health data (PGHD). Without these core capabilities, built directly into the EHR and not a bolt-on, the industry will continue to struggle in its attempts to truly manage the health of the population they serve.

Each month, subscribers to the Chilmark Advisory Services (CAS) receive an update of our research on the most transformative trends in the healthcare IT sector. Exclusive to CAS subscribers, Monthly Updates are part of the continuous feed of information and analysis we generate to keep subscribers on top of the rapid-fire changes in this market.

 

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