HIT Think

How federal EHR modernization shows need to better manage content

Register now

Federal health information technology (IT) spending reached nearly $6 billion last year, roughly 30 percent of the overall U.S. health IT spend. Driven by the efforts to modernize the U.S. Departments of Veterans Affairs (VA) and Department of Defense (DoD) health systems, it may reach $7 billion by 2021.

What was once just “talk” of updating existing tech stacks has transitioned into actionable discussions about replacing legacy IT systems. And with available commercial technology solutions that translate well into the public sector, the transition has become much easier, more efficient and cost effective.

The government has high interests in modernizing old existing healthcare systems, which have incurred duplicative functionality and workflows that lack configurability and cannot be easily updated. While improving the infrastructure, the future is top of mind as they move forward, such as developing apps and encouraging interoperability across federal and private healthcare organizations.

As outlined in the Defense Health Agency’s Long Range Technical Architecture strategy, in order to realize the benefits of innovation and technical architecture, the DHA must:

  • Consolidate and modernize its systems
  • Focus on improvements to strategy, governance and execution practices
  • Build a more fluid and flexible infrastructure
  • Maintain a proactive study of emerging technologies

Most recently, conversations centered on the electronic health record (EHR) system, similar to the DoD’s EHR, the Military Health System Genesis, that was chosen to replace the aging Veterans Health Information Systems and Technology Architecture (VistA.)

Most EHRs manage patient data and structured information, but it is important to note that even the best systems cannot manage the unstructured content—such as paper documents, faxes, images and photos—that originates outside of it. In addition to implementing an EHR, organizations must also consider a well-rounded information management strategy.

By integrating an enterprise information platform with healthcare information technology, federal healthcare providers may successfully connect disparate systems across their organization while also creating a single access point for clinical and administrative information.

Providing staff and clinicians with immediate access to a complete, secure patient record from within the familiar applications used every day ensures they have the information they need—when, where and how they need it. Instant access to critical information not only enhances the user experience, it also simplifies processes and supports an improved patient experience by empowering clinicians, staff and hospital administrators to make more informed decisions, faster—a crucial advantage when time is of the utmost importance.

This approach to comprehensive clinical data management resonated with the Defense Health Agency. Even as it modernizes its health IT system with a new commercial EHR, the agency has identified enterprise content management (ECM) as a critical component in its long-term technical architecture strategy.

As much as 65 percent of the patient record resides outside of the EHR, and federal health records systems are no different. Traditionally, to share this content with another health system or provider, healthcare organizations print, copy and deliver, or scan and fax the information. This unsecure, manual practice adds expense and time, which for healthcare organizations—public and private—is in high demand.

Clinical content comes in many forms, and although few in number, there are ECM systems capable of handling DICOM content and exchanging this data with other organizations. The advanced ECM solutions with vendor neutral archive (VNA) capabilities have solidified their position as an enterprise solution capable of securely capturing and storing DICOM and non-DICOM content, integrating with the EHR and securely sharing information electronically with other healthcare organizations – a capability that is both innovative and valuable.

By leveraging an integrated ECM and EHR solution, care transitions occur seamlessly as patient content transfers electronically from one organization to the next, another feature that could be incredibly valuable to the federal market.

The responsibility of transporting records no longer falls to the patient and clinicians starting from scratch to compile a collection of patient data. Fingertip access to patient information supports informed decision-making and confident patient care while also cutting costs by reducing duplicate tests and repeat services. This clinical content strategy is essential to the health data continuum and providing U.S. federal healthcare agencies with a roadmap for continuing to modernize and improve patient care.

Like its commercial counterpart, the federal government seeks proven technology solutions and looks to private-sector vendors to modernize its healthcare IT systems. Historically, ECM technologies were not widely promoted in the federal market. But, as most government agencies shed their legacy solutions in order to become more efficient in their delivery of healthcare, proven enterprise information platform technologies rooted in the private sector will play a critical role in enhancing its delivery of healthcare.

For reprint and licensing requests for this article, click here.