Technology and its interoperability continues to evolve, especially following the COVID-19 Pandemic that forced some rapid industry changes. If you’re a stats and facts fan, this piece is for you.
We’ll talk about the 21st Century Cures Act, including facts about top EHRs Cerner & Epic, the state of healthcare staffing, and how COVID played a part in changing the tech landscape.
General Interoperability Statistics and Facts
Let’s look at some general interoperability stats and facts. Many of these will demonstrate its importance and how many hospitals have incorporated aspects of interoperability over the past few years.
- Over 6 in 10 hospitals engaged in key aspects of electronically sharing health information in 2021. This is a 51% increase since 2017! (HealthIT)
- 2021 saw a stark increase in the availability and usage of electronic health information received from outside sources at the point of care — these numbers hit 62% and 71% over the past four years. (Healthcare Dive)
- Around 75% of hospitals participate in health information exchange organizations (HIEs), and another 35% of hospitals participate in both HIEs and national networks. (HealthIT)
- Over a third of hospitals (39%) reported participating in one or more of the four measured national networks. (HealthIT)
- Around 90% of hospitals upgraded their EHRs to the 2015 Edition through 2021. Additionally, 74% of hospitals adopted bulk data export technology over the same time period. (Healthcare Finance)
- In 2021, around 80% of hospitals electronically queried or found any patient health information. (HealthExec)
- The rates of integrating summary of care records increased by 21% and finding information increased by 19%. (HealthIT)
- Small and rural hospitals having electronically available information reached 50% in 2021. (HealthIT)
- In 2021, over 60% of hospitals used an HIE to find patient health information or electronically query from external sources. (HealthIT)
- 88% of hospitals participated in electronically sending and obtaining patient health information in 2021. (Medical Economics)
The 21st Century Cures Act
On December 13, 2016, President Obama signed the 21st Century Cures Act: a multifaceted piece of legislation aimed at advancing healthcare and medical innovation. This landmark act champions and allocates resources for research endeavors, expedites the progress of pharmaceutical and medical device development, and advocates for greater interoperability and wider acceptance of electronic health records (EHRs).
Here are some facts and insights about the bill courtesy of HIMSS:
- Vision for Interoperability - The legislation anticipates a robust federal involvement, led by the Office of the National Coordinator for Health Information Technology (ONC), in overseeing and advancing the standards for health IT regulation and development.
- Trusted Exchange Framework - The objective of the legislation is to promote increased interoperability by having the ONC facilitate collaborations between public and private entities to establish a "trusted exchange framework," which includes a universal agreement among national health information networks.
- Patient Focus - The law places significant importance on granting patients easy-to-understand, secure, and automatically updated access to their electronic health records.
- Low-Risk Medical Devices - The Food and Drug Administration is prohibited from overseeing mobile health applications intended for promoting or supporting a healthy lifestyle when they are not linked to the diagnosis, prevention, or treatment of diseases.
- Mental Health - The legislation advocates for a reevaluation and clarification of HIPAA rules concerning acceptable communication practices, particularly in cases where patients are grappling with substance abuse or mental health concerns.
- HIPAA Clarifications - The Secretary of Health and Human Services (HHS) will clarify HIPAA privacy regulations, specifying the circumstances under which family members and caregivers can access health information and receive notifications about treatment options on behalf of the patient.
- Interoperability and Information Blocking - Although the legislation is recognized for its support in funding efforts like precision medicine, it also includes provisions aimed at enhancing healthcare IT, particularly with regard to nationwide interoperability and addressing information blocking.
- EHRs are the key - A common, integrated electronic health record is the foundation that makes the required level of interoperability possible.
Let’s dive into some facts about two of the largest EHR providers: Epic and Cerner.
Epic
- Epic stores medical records for over 250 million people (Harmony Hit)
- Epic partnered with Humana in June of 2019 to advance interoperability and transparency between the two. (Becker’s Hospital Review)
- Epic's Cosmos program is designed to mine data from millions of patient medical records to improve research into treatments. (Becker’s Hospital Review)
Cerner
- Cerner has allocated over $7 billion in cumulative research and development investments. (MiraMed Ajuba)
- In July 2019, Cerner partnered with Amazon Web Services to increase efficiencies and modernize Cerner's platforms and software development. (FIERCE Healthcare)
- On Oct. 28, Cerner partnered with Uber Health on non-emergency transportation services, allowing providers to schedule Uber transportation through the Cerner EHR for patients. (Healthcare IT News)
Healthcare Turnover and Other Challenges
Unfortunately, healthcare professionals are often overworked and face certain challenges.
With the right implementation, interoperability could help eliminate and shift some of the workloads.
Here are some quick facts on turnover and healthcare challenges.
- Hospital turnover increased by 6.4% in 2022. It currently sits at 25.9%. (Healthcare Finance)
- Hospitals lost 2.47% of their RN workforce in 2022. (Healthcare Purchasing News)
- The turnover rate for staff RNs increased by 8.4% and currently stands at 27.1% as of 2021. (National Library of Medicine)
- The cost of turnover for a bedside RN is $52,350. This results in the average hospital losing between $6.6 million and $10.5 million. (NSI Nursing Solutions)
- The national hospital turnover rate sits at 25.9% — however, in the past five years, the average hospital turned over 100.5% of its workforce. (Healthcare Finance)
- As of 2021, voluntary terminations accounted for 95.5% of all hospital separations. (Oracle)
COVID-19’s Impact on Interoperability
The pandemic affected nearly every aspect of healthcare — including interoperability.
Here are some key facts related to the role of interoperability throughout COVID-19 courtesy of EHR Intelligence:
- COVID-19 & interoperability - As the COVID-19 pandemic began to spread, there were worries that interoperability and the functionality of Electronic Health Records (EHR) systems might impede efforts to manage the virus. Nonetheless, health systems and IT vendors worked together to enhance EHR and health IT systems to meet the demands of the pandemic.
- Cerner’s response to COVID-19 - Cerner enhanced its Electronic Health Record (EHR) platform by broadening its telehealth capabilities, integrating disease screening tools, and modernizing EHR dashboards. Additionally, they demonstrated support for frontline workers by waiving licensing fees.
- AdventHealth's transition - AdventHealth, a prominent healthcare system, revealed its decision to shift from Cerner to Epic Systems' Electronic Health Record (EHR) system, aiming to consolidate its operations onto a unified and integrated platform.
- COVID-19 & data exchange - The pandemic underscored the significance of health data exchange and interoperability. There was a call for the United States to emulate the capabilities of countries that effectively controlled the virus, largely attributed to their adeptness in exchanging not only medical but also non-medical data.
- Veterans Health Administration's CAN score - The Veterans Health Administration (VHA) created the Care Assessment Need (CAN) scoring system, a risk stratification tool that utilizes Electronic Health Record (EHR) data. This tool was developed to assist ambulatory care teams in identifying high-risk outpatients amidst the challenges posed by the pandemic.
- ONC Interoperability Final Rule - The Department of Health and Human Services (HHS) officially approved the interoperability rule proposed by the Office of the National Coordinator for Health Information Technology (ONC). This rule was designed to empower patients with greater control over their health data while aiming to eliminate information blocking.
- Epic Systems & Google Cloud - Epic Systems opted not to pursue further integration with Google Cloud due to concerns regarding patient privacy, which had arisen from Google's collaboration with Ascension.
- Remote EHR implementation - Due to COVID-19-related travel restrictions, Epic Systems initiated its inaugural remote Electronic Health Record (EHR) implementation. Valley Children's Healthcare in California successfully completed this remote implementation process.
- ONC's stance on information blocking - The Office of the National Coordinator for Health Information Technology (ONC) took a firm stance against information blocking through its interoperability rule, with the objective of ensuring that health IT developers are held accountable for their actions.
- Epic Systems Community Connect - Midsize to large ambulatory health facilities that opted for Epic's Community Connect model reportedly expressed lower levels of satisfaction compared to those who directly engaged with the vendor.
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