Electronic Health Records: Is Corporate Profitability Key to Innovation?

Strategically, the EHR data interoperability model, where patients’ data efficiently flow from a hospital to LTC pharmacies and to LTC facilities, provides a tremendous strategic expansion opportunity for LTC pharmacies.

·        Once the model is prototyped to be successful, other LTC facilities will want to be a part of the network. Thus, LTC pharmacies have a chance to expand into facilities where they do not currently serve.

·         With this innovative product, LTC pharmacies’ sales and account management team would have an upper hand while negotiating new contracts or contract renewals.

From a cost savings perspective, LTC pharmacies can reduce costs with a smart medication dispensing system. Once an LTC pharmacy receives the patient’s data, and before it transmits the data to LTC facilities, the LTC pharmacies can add logic into its software to include “value added information” that will help nurses and doctors to make data-driven decisions at the LTC facility.

·         A patient’s CCD, which is the electronic version of a patient’s discharge instruction file, lists the medications to be administered. If a prescribed medication is unavailable at an LTC pharmacy serving a facility, the software can recommend an alternative medication. The National Institute of Health offers an application programming interface (API) to identify alternative medications. Thus, expensive delivery costs to procure medications at the last minute can be reduced.

·         Brand name drugs can be substituted with generics, resulting in cost savings for both the pharmacy and the patient.

·         Logic can be built into the software to identify any possible drug interactions. Any concern can be flagged to the nurses and doctors.

·         A number of LTC pharmacies have medication cabinets in the LTC facility. These cabinets are usually spread out into several floors. Because pharmacies usually have the cabinet inventory up-to-date, the software can identify whether the medication is available and the exact cabinet with its location where the medication or its alternative is located. With this information, nurses will not waste time trying to search for the medication in various cabinets on different floors. Satisfied nurses will drive product adoption.

·         Medical errors arising due to negligence can be reduced. Moreover, with patients’ data easily accessible, providers are less likely to order lab tests that were previously conducted, thus reducing costs.

Advertisement: A happy customer (patient) will recommend the LTC facility to others. This first-hand word-of-mouth advertisement presents an amazing growth opportunity for both the LTC facility and the LTC pharmacy.

Challenges

·         The primary challenge will be the adoption of the product at LTC facilities. The initial version of the product will not be 100 percent consistent. Product adoption may suffer if nurses do not have confidence in the new system.

·         The adequacy of the IT infrastructure at LTC facilities is another dependency. LTC facilities and their EHR software vendors must work together to provide reliable support.

·         Hospitals move very slowly. Any request from nurses that involves making changes at the hospital’s end will need time to implement.

·         Cultural shift: At the hospitals, nurses entering any comments about the medication or allergy must enter them in the comments or observations column. Although this is the expected norm, hospital nurses usually enter their comments and observations in any adjacent column. However, comments need to be entered in the correct column for the software to effectively parse and display the information.

·         Logistics: The HIPPA, PHI, and PII laws prevent a patient’s health information from unauthorized access. Therefore, any fax coming to the LTC facility containing a patient’s health information should be easily accessible to the nurses involved. The fax machines should not be far away or in a different floor; else, accessing the fax will become a hassle, and this will affect product adoption.

The Future

In the future, more innovation should be expected. The government understands the need to have an interoperable platform. There will be regulations streamlining the data exchange, but this will take time.

Hospitals have an intangible incentive to work with LTC pharmacies, because if the patient receives good care, the chances of the patient being re-admitted reduce significantly. The Center of Medicare and Medicaid Services uses excess re-admission ratios to measure a hospital’s performance and to penalize hospitals for excess re-admissions under the 21st Century Cures Act.

There are growing expectations from patients that their data should be safely and easily accessible. Technology has made data easily available. Therefore, shouldn’t data also be available and accessible for the healthcare system?

Regulations and corporate profitability will bring innovation to the EHR system. Subsequently, the expectations and demands to urgently resolve interoperability issues will be high.

In conclusion, corporate profitability is key to the innovation of the healthcare sector. The EHR segment is no exception. Owing to regulations surrounding HIPPA and PHI data, patients’ medical information is very tightly controlled within an entity. An entity may be a hospital or an LTC pharmacy or LTC facility. Any data transferred to external entities go through a stringent legal review. When there is so much at stake, a sizable corporate profit is the only route toward encouraging innovation.

Aloke Sinha works in the project management office at CVS Health