Pennsylvania conference highlights connected care challenges

An annual meeting of IT folks from Pennsylvania’s healthcare community looked at where the state has made progress with connecting physicians and patients and what still needs work. Not surprisingly, the needs work column is a lot longer than a checklist of accomplishments. The second installment of the annual event is hosted by Pennsylvania eHealth […]

An annual meeting of IT folks from Pennsylvania’s healthcare community looked at where the state has made progress with connecting physicians and patients and what still needs work. Not surprisingly, the needs work column is a lot longer than a checklist of accomplishments. The second installment of the annual event is hosted by Pennsylvania eHealth Partnership Authority.

Dr. Richard Snyder, Independence Blue Cross CMO, highlighted its work with entrepreneurs through its support of DreamIt Health. But Snyder, who worked as a primary care physician also emphasized the need to understand physicians’ electronic medical record workflow needs. As useful as some data might seem for physicians to have, the rain of data into EMR systems is unproductive unless it is adding useful context and helping the physicians’ workflow. “We have to be very selective about what [data] we give and how we give it [to physicians].”

The pace of connecting hospitals in health information exchanges has been mixed for different parts of the state. Regional HIEs have been more practical to set up. A pie chart of health systems in the Philadelphia area (pictured above)  illustrated why HIEs are so critical but challenging to implement even as consolidation has whittled down the number of players in the region.

Even for hospitals that are connected and using an EMR, many of patients who, say, come into the emergency room not just from Philadelphia but neighboring states like New Jersey and Delaware may not have one. In Philadelphia, some hospitals are using Independence Blue Cross’ clinical care reports which are not designed to replace EMRs but are being used to provide snapshots of the patient’s treatment and things like medical tests and medications prescribed to patients.

Bridging the acute care environment with the post acute care environment is one challenge that several health IT companies have been working on, including RightCare Solutions. Atul Shah, who joined the company earlier this year, pointed to the clinical challenge of making these care transitions for patients with a high risk of being readmitted — a challenge the company’s care transitions platform is designed to address. He said he sees the hub and spoke model as the best way to solve some of these gaps — leveraging a hospital’s health IT infrastructure using higher network applications.

But as one audience member pointed out, one of the biggest dilemmas states are facing is the healthcare technology is at a point where it is ahead of the curve in adoption. It has come to a point where the technology needs to be proven safe and effective for patients if clinicians are to be expected to adopt it. “It is not an IT issue, it is a clinician issue. We can’t go so fast that we trample clinicians.”

Like a lot of states with significant rural populations, Pennsylvania has a lot of independent physician practices that have been challenged to keep up with the pace of the health IT transformation. In the next few years there may be a shift to larger group practices that are more sustainable in an environment where doctors can more easily balance the needs of patients with keeping up with the push for connected care.

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The state’s eHealth Partnership Authority is expected to release a report later this year highlighting opportunities for better care coordination and care delivery.