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Year in Review: Most Read EHR, Interoperability Stories of 2020

COVID-19 put interoperability and electronic health records (EHRs) under the microscope in 2020.

As one of the most tumultuous years in healthcare delivery draws to a close, the most read stories of 2020 spotlight the biggest concerns, challenges, and innovation areas that were top of mind for industry stakeholders, including EHRs, interoperability, and the national emergency brought on by COVID-19.

When COVID-19 began to make its way across the country, healthcare leaders expressed concern that challenges with interoperability and EHR functions would stymie attempts to mitigate the spread of the virus.

However, health systems, health IT experts, and health IT vendors worked together to quickly optimize both EHR and health IT systems to adapt to the unknowns of COVID-19.

This year’s most popular EHR and interoperability stories on EHRIntelligence range from several Epic Systems headlines, EHR optimization, and of course, the impact COVID-19 had on interoperability and patient data exchange.

HIMSS20 Canceled Due to Coronavirus Outbreak

HIMSS20 was one of the first major events canceled due to the coronavirus outbreak.

As several major healthcare organizations canceled their participation, a statement on the event’s website stated that HIMSS would not hold the annual conference in 2020 to ensure the safety of its attendees.

“We recognize all the hard work that so many have put into preparing for their presentations and panels that accompany every HIMSS conference,” Hal Wolf, president and CEO of HIMSS, stated on the event’s webpage. “Based on evaluation of evolving circumstances and coordination with an external advisory panel of medical professionals to support evidence-based decision making, it is clear that it would be an unacceptable risk to bring so many thousands of people together in Orlando next week.”

How Cerner is Using EHR Optimization to Combat COVID-19

Following the first reported cases of COVID-19, Cerner updated its EHR platform to expand its telehealth capabilities, implement disease screening tools, and update the platform’s EHR dashboards.

The EHR vendor also implemented telehealth solutions and waived licensing fees to expand hospital beds at health systems, to support frontline workers responding to the pandemic.

Cerner put together a COVID-19 Taskforce to focus on how the company would help its clients and associates tackle this pandemic.

Major Health System Drops Cerner EHR, Signs on with Epic Systems

AdventHealth, a Florida-based health system and one of the nation’s largest faith-based health systems, announced it would gradually transition away from Cerner and implement Epic Systems EHR across its 50 hospital campuses and 1,200-plus care sites that range over nine states.

The Epic implementation is designed to bring the giant health system to a single, integrated platform, which will include its EHR and a revenue cycle management system for its acute care, physician practices, ambulatory, urgent care, home health, and hospice facilities.

AdventHealth expects the project will be completed within three years.

COVID-19 Exposes Lack of Health Data Exchange, Interoperability

The spread of the COVID-19 pandemic was not only a significant stress test for the entire healthcare system, but it put the importance of health data exchange and interoperability under a microscope.

Niam Yaraghi, a fellow in governance studies at the Center for Technology Innovation at Brookings Institution, penned an op-ed to explain why he thought the US lacked health information technologies to stop or contain the COVID-19 epidemic.

“The pandemic has shattered our common beliefs about the type and scope of health information exchange (HIE),” wrote Yaraghi. “It has shown us that the definition of health data should no longer be limited to medical data of patients and instead should encompass a much wider variety of data types from individuals’ online and offline activity. Moreover, the pandemic has proven that healthcare is not local.”

The author noted there are a select number of countries that have the ability to contain the coronavirus because of their ability to exchange non-medical data, and the US should work to replicate those capabilities.

How VA Used EHR Data for COVID-19 Risk Assessments

As part of its response to the coronavirus pandemic, the Veterans Health Administration (VHA) developed the Care Assessment Need (CAN) scoring system, a risk stratification tool that leverages EHR data.

CAN scores aim to support ambulatory care teams in the systemic identification of high-risk outpatients to better target resources. The ability to predict a patient’s clinical course could also enhance patient care, family counseling, resource allocation, and social distancing strategies.

Researchers plan to assess whether the CAN score can be used to improve the VA’s ability to stratify patients according to risk for those diagnosed with COVID-19.

As a result of the study, researchers noted the CAN score is directly correlated with and has the ability to predict the majority of patient outcomes.

The odds of a deadly outcome increased by almost 4 percent for every unit-increase in the CAN score and mortality prognoses are the most reliable. Meanwhile, mechanical ventilation and ICU stay outcomes are the most difficult to predict based on CAN scores.  

ONC Interoperability Final Rule Clarifies Information Blocking

In March, the Department of Health and Human Services (HHS) finalized the Office of the National Coordinator for Health Information Technology’s (ONC) interoperability rule, intended to provide patients with more control of their health data and to eradicate information blocking.

The ONC final interoperability rule worked to clarify that definition.

In the finalized rule, ONC defined eight exceptions that will not be considered information blocking by actors, who are defined as healthcare providers, developers of certified health IT, health information exchanges, and health information networks.

These eight information blocking exceptions were divided into two categories:

  • Not fulfilling requests to access, exchange, or use electronic health information (EHI)
  • Procedures for fulfilling requests to access, exchange, or use EHI

These provisions combined with new regulations that aim to grant better patient data access.

Epic Systems Calls off Google Cloud Deal After Privacy Scare

Back in January, Epic Systems told its customers that it will no longer pursue further integration with Google Cloud, as it had not seen enough excitement around the partnership.

This followed Google’s backlash regarding its work with Ascension, a large Missouri-based health system. Media reports outlined a series of industry criticism, stating that patient privacy was breached after Google employees gained access to Ascension patient health information when the information was transferred over to Google’s servers.

With Epic distancing itself from the tech giant, Google took a significant financial hit.

Instead, Epic shifted its focus to Amazon Web Services (AWS) and Microsoft Azure for a cloud-based technology provider to utilize for medical research, data storage, and file sharing.

Epic told CNBC there are several factors when considering third-party partnerships. However, the company did not specifically comment on Google.

Epic Systems Takes the Leap to Remote, Virtual EHR Implementation

COVID-19 travel bans made it challenging to do a traditional in-person EHR implementation, which requires numerous EHR vendor support staff to be on-site at the hospital.

Following Cerner’s first-ever virtual implementation, Epic Systems launched its own remote implementation. In May, Valley Children’s Healthcare, which provides care for over 1.4 million children in the Madera County area of California, completed Epic’s first-ever remote, virtual EHR implementation.

Not only was the entire go-live process conducted remotely, but Epic and Optimum Healthcare, a staffing and consulting services firm, teamed up to migrate seven different EHR platforms into one Epic EHR platform.

This was the first time a third-party vendor engineered a 100 percent virtual go-live.

ONC Final Interoperability Rule Drops, Targets Information Blocking

On March 9, ONC officially released the next phase of the 21st Century Cures Act; the interoperability rule, which primarily centered around interoperability and patient information blocking.

The published rule is designed to drive patient access and sharing of their electronic health information, allowing individuals to coordinate their own healthcare.

It also took a strong stance against information blocking and aims to hold health IT developers accountable as a Condition of Certification.

There were much debate and controversy during the proposal period. Epic Systems openly disapproved of the rule, with Epic CEO Judy Faulkner urging clients to sign a letter to HHS. However, those privacy concerns were addressed by ONC in the final rule.

Epic Systems Community Connect Users Completely Unsatisfied

Midsize to large ambulatory health facilities that chose Epic’s Community Connect model were reportedly less satisfied than those that chose to work directly with the vendor.

A large ambulatory facility has two choices for connecting to the Epic EHR network: direct contracting through the vendor, or via Community Connect, which relies on a contract with a nearby hospital.

Community Connect is a cost-effective program that allows hospitals to connect to a larger local hospital in order to connect to the Epic EHR network. It enhances interoperability with the nearby health system, thus, increasing referrals and providing a lower cost EHR implementation.

While Community Connect has its advantages, the report found that midsize to large ambulatory organizations had a better experience when dealing directly from the vendor.  

On the other hand, those who utilized the Community Connect platform said they were less satisfied. They also blamed Epic for allowing host organizations to deliver a sub-par experience compared to its usual high standard.

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