EHR: How Technology is Making Healthcare Healthier

Advances in high-speed technology and new ARRA stimulus funding are ushering in a new era in Electronic Health Records in the U.S.

Hopefully, you haven’t had to use a hospital emergency room lately. But if you have, you’ve probably noticed some changes since the last time you were there. First, the ER is likely to be more crowded as more and more people lacking insurance use hospital emergency services for primary care. Second, the old paradigm of waiting to be called, then sitting at a desk while a clerk or nurse fills out a ream of paperwork is fast disappearing.

Today, ER patients are just as likely to be visited by admittance personnel who use a handheld computer to enter information electronically. Next, a nurse may use the data with a diagnostic aid tool to do initial triage. An ER physician then reads the report, examines the patient, orders tests if necessary, and sends the data electronically to other physicians or teams, and treatment begins. At the same time, the data is sent to financial services for insurance purposes, and it is also stored in the patient’s personal electronic health record. Results are significant for patients: faster care, better diagnostics, real-time treatment tracking, improved outcomes. They are just as significant for hospitals, including increases in ER collections from 20 to 50 percent. In other words, everybody benefits. And emergency departments are just one of the beneficiaries of EHR solutions.

The Promise of EHR

While healthcare reform legislation is winding its rocky road through the U.S. Congress, virtually everyone involved in healthcare—from patients to physicians to politicians—has a positive attitude toward electronic health records initiatives. It starts at the very top. As early as 2005, President George W. Bush stated, “We’ve got 21st century medical practices but a 19th century paperwork system… medical electronic records (will) be one of the greatest innovations in medicine.”

Four years later in a February 2009 address to a joint session of Congress, President Barack Obama noted, “Our recovery plan will invest in electronic health records and new technology that will reduce errors, bring down costs, ensure privacy and save lives.” The President is backing up his words with action, including provisions in the American Recovery and Reinvestment Act (ARRA) that make some $20 billion in funding for Health Information Technology (HIT), including electronic health records. These incentives will be available as reimbursements by the year 2011 and beyond. They will be provided to hospitals and other healthcare organizations that comply with certain certification standards and can document that they are making “meaningful use” of the technologies as defined by ARRA, the Department of Health and Human Services and other organizations. .

The State of Technology

Key to gaining certification and making meaningful use of HIT and EHR are high-speed wired and wireless infrastructures creating backbone networks that work in concert with innovative software solutions and advanced hardware devices such as powerful handheld computers. These communications technology solutions are the foundation for comprehensive health information systems that speed information from the bedside to the laboratory to physicians, nursing and healthcare support personnel. Among the most important functionalities today’s communications technologies must deliver are accurate data capture, stringent data security and real-time data sharing.

Capturing and Collecting Data

Electronic healthcare data collection begins with the capture of patients’ personal healthcare histories on computers and mobile computing devices. This information becomes part of a permanent health record that can be accessed and utilized throughout the entire healthcare continuum, providing real-time clinical decision support at the point of care. Computerized Physician Order Entry (CPOE) data adds to this record, as physicians enter their orders into a computer rather than on paper. Implementation of CPOE is estimated to be capable of preventing millions of serious medication errors every year, as well as decreasing the length of hospital stays, reducing redundant testing and shortening laboratory, pharmacy and specific service (such as radiology) requests’ turnaround time. Treatment outcomes can be improved significantly and overall cost savings can be substantial for patients, individual healthcare providers and the industry as a whole.

Protecting Data

One of the most sensitive issues with EHR is concern about Health Insurance Portability and Accountability Act (HIPAA) compliance and questions about how successfully electronic records can keep patient medical records from being seen and used by unauthorized entities. To that end, a U.S. HIT Standards Committee is working to establish comprehensive privacy/security standards that set stringent security criteria both for internal and external data exchange.

On his blog “Life as a Healthcare CIO,” Dr. John D. Halamka, CIO of both Harvard Medical School and Beth Israel Deaconess Medical Center, notes that the Standards Committee’s work sets “… authentication, authorization, auditing and secure data transmission standards (and includes) standards for use in EHR products, the infrastructure that hosts them and best practices.” The Committee is also examining security adoption and implementation issues. And, although today’s data protection is generally very good, the committee’s work will provide for even higher levels of security as EHR becomes more and more prevalent.

Sharing Data

To fulfill the promise of EHR, each patient’s health history and records must allow real-time access across the continuum of care, both inside and outside the hospital’s four walls. Record sharing must include physician offices, clinics, EMT usage, hospitals and medical centers, stand-alone treatment centers, rehabilitation facilities, home care organizations and more. At the same time, access to records must be tightly restricted to only those professionals with a true “need to know.” To this end, a Nationwide Health Information Network (NHIN) is being developed to provide a secure, interoperable health information infrastructure to connect virtually all healthcare constituents.

The U.S. Department of Health and Human Services (HSS) reports that this “Nationwide Health Information Network is being developed to provide a secure, nationwide, interoperable health information infrastructure that will connect providers, consumers and others involved in supporting health and healthcare.” One of its most important objectives is to make it easy for health histories and data to follow the patient, making point-of-care decision-making and treatment faster, more appropriate, more accurate and more successful.

Standards Harmonization

Interoperability, or the ability of disparate technology platforms to work together is essential to the streamlined sharing of EHR. The goal is true standards harmonization, but the fact is, older standards, devices and technologies have not been very successful at providing for interoperability.

Addressing this challenge is an initiative called Integrating the Healthcare Enterprise (IHE), a group consisting of healthcare professionals and industry experts focused on improving the way healthcare computer systems share health data. Also working on the issue is the Continua Alliance, a non-profit, open industry coalition of healthcare and technology organizations. Progress is being made.

In late summer of 2009, the two groups agreed on a set of specific interoperability standards. Writes Dr. Halamka in his blog, “[The groups] have agreed to a single set of content, transport, and vocabulary standards that work for all devices, home-based and hospital-based, simple and complex. This means that the industry is free to innovate and regardless of the devices created, they will be interoperable.”

Motorola EHR Solutions Leadership

Motorola is a leader in the movement to EHR. As a pioneer in wireless technology solutions, the company is a trusted, long-standing communications partner of local, state and federal governments, providing fixed and mobile wireless broadband networks, indoor wireless networks, powerful network security technologies and rugged and reliable mobile computing devices. Not surprisingly, more and more healthcare institutions and professionals are now working with Motorola, and our software partners, to provide the technology and the integrated and interoperable solutions to streamline implementation and operations of advanced EHR systems.

Motorola Healthcare Technology Solutions

Motorola’s portfolio of wireless and mobility solutions is proven to deliver the speed, access, reliability and security to support EHR and help bring the best possible care to every patient. Motorola solutions include:

• Motorola Handheld Computers are rugged and intuitive, and enable healthcare professionals—including ER personnel, nurses, physicians, EMTs and many others—to capture information quickly and accurately and transmit the data securely and in real-time.

• Wireless Local Area Network (WLAN) solutions provide secure and reliable indoor mobility and communications at the point of care, enabling faster and more accurate connectivity between physicians, nurses, laboratories and pharmacists, ultimately improving care and increasing efficiency.

• Wireless Broadband. Motorola’s Point-to-Point (PTP) solutions provide the health information technology for backhauling data files between two locations. Point-to-Multipoint (PMP) solutions provide high-speed connectivity to multiple locations and facilitate collaborative medicine. Mesh Wide Area Network solutions provide fixed and mobile high-speed communications over a wide area, enabling hospitals, EMTs, clinics, labs and other locations to transmit medical data exactly when and where it’s needed.

• Motorola’s TEAM VoWLAN mobile access solution provides physicians, nurses and other on-the-move professionals and staff with phone service, texting, e-mail, high-speed Internet and Intranet access and access to applications all on a single device that fits into a pocket.