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CHIME Most Wired survey: Interoperability slowly moves forward

CHIME released its first Most Wired survey at its Fall CIO Forum, and found that the road to interoperability remains bumpy -- but there are signs of improvement.

SAN DIEGO -- CHIME’S first Most Wired National Trends Report found that access to patient health information is becoming more common in healthcare, but there are still significant challenges to interoperability.

The Most Wired survey, which has been conducted for 20 years, has historically focused on measuring HIT technology adoption and to put a spotlight on organizations that have the deepest and broadest IT infrastructure. This year -- CHIME’s first at heading the Most Wired program --  sought to drive change in the healthcare industry with the goal of improving patient safety and outcomes, according to Most Wired Board of Governor’s chair William Spooner. The American Hospital Association previously ran the survey.

According to the Most Wired survey, nearly all of the 618 participating organizations reported that at least 95% of their clinicians regularly access clinical information electronically. That information includes patients’ medical histories, care plans, discharge instructions and clinical summaries. However, only about of the half of the physicians are able to access that same information from a mobile app. Similarly, secure messaging lacks the same adoption of other remote-access functions. The survey notes that both of these technologies represent opportunities for the healthcare industry to advance its current communication infrastructure.

“We’re making great progress with the interoperability, but there’s still work to do,” consultant Drex DeFord, president of Drexio Digital Health, told CIO Fall Forum attendees here this week.

Security still needs work

We’re making great progress with the interoperability, but there’s still work to do.
Drex DeFordpresident, Drexio Digital Health

In terms of security, the report found that many provider organizations are shifting from self-developed security frameworks to established frameworks, such as the one set up by the National Institute for Science and Technology. But the fact that some providers still use their own frameworks concerned DeFord.

“I still kind of scratch my head that about 20% of you are using self-developed security frameworks when there are other good frameworks to use,” DeFord said. 

According to the Most Wired survey, only 29% of healthcare organizations have a comprehensive security program in place. Among those who don't have such a program, 31% either do not meet with their executive committee or meet with the committee less than once a year to give a security update.

How is population health interpreted?

The Most Wired survey noted that population health management technology can provide healthcare organizations with the necessary tools to move toward value-based healthcare. However, those tools are still incomplete, said Spooner, the former CIO of San Diego-based Sharp HealthCare.

“Population health is a little more difficult to interpret because different organizations are doing different things,” Spooner said.

While risk stratification and outreach targeting are becoming common, and population health tools are becoming more widely adopted, at-home chronic disease management technology adoption is only growing slowly. Most providers target diseases like chronic obstructive pulmonary disease, congestive heart failure and diabetes, but few track other conditions like behavioral health and sickle cell anemia. Few organizations allow patients to submit self-test results or send medication management compliance updates via email.

Patients are engaging, but only for certain tasks

Meaningful use aided the development and use of patient portals, according to the Most Wired survey, and patients have readily transitioned to mobile apps offered through those portals.

However, they are not using logistical tools such as meal ordering, discharge functions or environmental controls. Instead, they engage with email and entertainment and satisfaction surveys. One way to help improve patient engagement is price transparency, the survey noted.

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