Developing A Single Patient Engagement Platform Across All Care Settings

Partners HealthCare is a non-profit, health system located in Boston that created a data based transformation (Davenport, 2013). It integrated a new system that aligned the participating organizations to cohesively run as one and to help shape the future of the organization. The system didn’t stop there as it was responsible for bettering the patient financing experience and the delivery of healthcare information to other organizations (Davenport, 2013). The initial goal of the organization was making patient care more affordable and accountable by providing integrated, evidence based, patient-oriented care.

Two organizations migrating to a common health information system would need a system that meets current regulatory requirements, meets the needs of the combined organization and their practice environment. The implementation of a common health information system would require an interdisciplinary group of forward thinking innovators, and an interoperable electronic medical record system that includes standard nursing terminology.

The high cost of healthcare continues to rise and many in the United States are optimistic for health information technology to reduce and improve our current situation. Health IT encompasses a broad array of new technologies designed to manage and share health-related information. When properly implemented, these systems can help coordinate patient care, reduce medical errors, and improve administrative efficiency. Therefore, implementing a Regional Health Information Organization (RHIO) will help the National Health Information Network (NHIN) achieve their goals in improving quality of care for the citizens of the United States. Thus, in order for the health IT to deliver on its promise, several obstacles must be overcome.

Athenahealth is an organization which understands that in today’s health care market, organizations can become overwhelmed with overly wasteful and disorganized administrative systems. Athenahealth is aware that these outdated systems can sometimes impede quality of care. However, their organization strives, as a single entity, to address these concerns by becoming the nation 's premier health care systems provider and empowering patients to be as actively involved in their care as they want to be. Their open technology platforms readily support improvement by providing consistent innovation and encouraging others to become a part of their mission. Their company is tirelessly developing new tools and services for the benefit of everyone involved with the health care field.1

In some areas of population health, technology in enhanced patient information is utilized to perform risk stratification to identify the high risk patients. These patient’s often have uncontrolled BP, diabetes with an HgbA1c over 9, COPD, etc. Once identified as high risk or potential high risk, these patients receive additional care or patient outreach to help manage their condition. Some organizations employee RN Health Coaches and Care Coordination teams to help these patients and identify gaps in care. The primary care physician assumes care of the patient along with striving for the patient to become active in their overall health thereby keeping them out of the hospital (Sanford, 2013). One enhanced area of population management is the PCMH model. PCMH practices increase patient’s engagement in shared decision making while providing compensation for care coordination, care management and medical consultation outside of traditional face-to-face visits (Berryman, Palmer, Kohl &Parham, 2013). A patient centered approach pushes for changes not only in the delivery of medicine but in traditional encounters. In addition, PCMH encourages increased access to the patient’s primary care physicians and improved patient satisfaction scores. PCMH and population health encourages providers to increase after hours care to decrease emergency department visits and/or hospitalizations. Thereby reducing cost and improving the patient’s

The American Recovery and Revitalization Act of 2009 brought meaningful use of patient records to help increase the improvement of patient care. With certified electronic health record technology, one goal is to improve quality, safety, efficiency, and to decrease health discrepancies. Some more goals are to get patient and family engaged in their care, continue to improve care coordination, and maintain privacy and security of patient health information. In order to achieve these goals, healthcare facilities must continue to stress the importance of patient engagement and to use the patient portal for healthcare information (“Meaningful Use Definition,” n.d.). Patient engagement is defined as a person’s continued participation in dealing

Since consumers are becoming more involved with their healthcare decisions, organizations and providers must adapt to consumer requisites and utilize independent resources to ensure the viability of their businesses. In 2008, a study reported that 81% of internet users and 66% of adults utilized online health information as a source for health related issues (Ha & Yun, 2011). Some examples of online health information resources comprised of search engines, organizational websites, and governmental agencies that participate in health related issues (Ha & Yun, 2011). By accessing health related information, consumers empower themselves with knowledge to assist in healthcare decisions and wellness management (Ha & Yun, 2011). As a result of consumers becoming better educated about healthcare, administrators must explore internet resources in order to maintain quality and services that is expected by consumers, and maintain the reputation of the organization.

Grand Hospital incorporated currently uses a proprietary healthcare information system that includes a patient portal, electronic medical records, computerized physician order entry, imaging, laboratory and pharmacy. Grand Hospital’s leadership is investigating creative resolutions to improve current physician service coverage, including ICU, radiology, and behavioral health via the implementation of telemedicine into the current system. (Wagner, Lee, & Glaser, 2013)

Healthcare reform has created incentives to increase patient engagement to increase accountability, healthcare outcome and lower healthcare cost. In the early days of this movement, web portals were created with basic functions of requesting appointments, prescription refills, and paying medical bills (Butterfield, 2013). Today, patient portals allow users to access dictated visit reports, labs, approve access controls combined with the function of the web portals. As more health information is pushed to the portals, the users (patients and family) are more involved with healthcare decisions and more knowledgeable on available options that meet individual need.

Changes in current health care practices, the aging baby-boomer population, and the higher acuity of patients has created a need for change and adaptability with the health care industry. Kaiser is an organization who has shown the ability to continuously change in order to reduce costs while improving efficient quality patient care. The investment on information technology (IT) advancements such as the implantation of electronic health records (EHRs) and use of a patient portal system is one way the organization has shown readiness to meet the health care needs of patients. KP in collaboration with five other healthcare organizations created a Care Connectivity Consortium, enabling secure electronic retrieval of current

Advances in modern technology surrounds us in our day to day lives, allowing conveniences and efficiency at our fingertips. Great strides have been made over the years with technology, and the healthcare industry along with many other industries have adopted this new way of functioning; electronically. The effects of technology have come to the forefront in where our government has acknowledged the benefits and opportunities. “The promise of Health Information Technology for improving quality and safety of health care while reducing costs has caught the eye of policy makers and other leaders in health care” (Hersh, 2006). It deeply affects how we connect, interact, and communicate internally and externally, but also gives us a sense of control on how we engage ourselves to the innovative software and systems.

Health Information Exchange is the electronic movement of healthcare information amongst organizations according to the national standards. HIE as it is widely known, serves the purpose of providing a safe, timely, and efficient way of accessing or retrieving patient clinical data. Health Information Exchange allows for doctors, nurses, pharmacists, and other vital healthcare professionals to have appropriate access and securely share vital medical information regarding patient care. Health Information Exchange has been in efforts of developing for over 20 years in the United States. In 1990 the Community Health Management Information Systems (CHMIS) program was formed by the Hartford Foundation to foster a development of a centralized data repository in seven different geographically defined communities. Many of the communities struggled in securing a cost-effective technology with interoperable data sources and gaining political support. In the mid-1990s a similar initiative began known as the Community Health Information Networks (CHINs) with the intention of sharing data between providers in a more cost-effective manner. In 2004, the Agency for Healthcare Quality and Research Health Information Technology Portfolio was funded $166 million in grants and contracts to improve the quality and safety to support more patient-centered care. This was the beginning of the progress we have seen in HIE today. Health Information Exchange devolvement serves the purpose of improving

A patient centered medical home (PCMH) could integrate patient care. A patient centered medial home is a team of healthcare providers coming together to improve the health of a specific population. A PCMH is designed to integrate primary care and specialists into improve care coordination, safety and quality.(Stange, et al 2010) A PCMH would also improve physician training and development to provide a commitment to treat the whole patient, rather than just one part.(Stange, et al 2010) Healthcare fragmentation can also be limited through improved communication between providers using e-mail and social media tools such as facebook and twitter.

The Computerized Provider Order Entry is effective program to help organization improve quality measures and financial margins. The CPOE is effective program; which monitors a hospitals current performance and calculates methods of improvement. For example, Trinity Hospital a leader in clinical intelligence to track and report across it members hospitals on systems wide quality measures (Balgrosky, 2015). The Clinical Provider Order Entry will help patients compare programs graded by the Center for Medicare & Medicaid and Hospital Quality Assurance. This program will further enhance the patient-centric model because patients will have comprehensive comparison of hospitals to make informed medical decision as to where they would like to receive treatment. The quality measures monitor readmission, complications, patient’s experience surveys and other categories. Patients are interested in receiving health care in top-notched care facilities that address their needs. Consumer needs are very important because translating into referrals by word-of-mouth or rankings. Technology plays a major role in an organization's success with supports Judy Murphy idea of enhancing patient’s health information technology

The variation in information needs across any healthcare provider organization forces healthcare information technologies (HIT) platforms, systems, processes and procedures to align its design to support the unique information needs of each department and role. The greater this alignment of HIT systems and technologies to specific administrator, doctor, nurse and lab technician roles, the higher the level of overall systems performance and results attained (Agrawal, Grandison, Johnson, Kiernan, 2007). Just as an enterprise has strategic information needs that help to define the future direction of the business, healthcare provider organizations also have a comparable set of strategic information needs. The administrative roles in healthcare providers need to have a consolidated view of the organization from a cost, quality management, service level, patient recovery rate, patient satisfaction and profitability standpoint as well (Middleton, 2005). All of these factors are often gathered together in a dashboard that administrators often rely on to manage the core areas of their healthcare business (Leung, 2012). Administrator's information needs are also longer term in nature and more oriented towards the development of strategic initiatives that will last several years, requiring