Moving into 2018, hospitals, health systems, and doctor offices will continue to struggle with the maintenance and implementation of electronic health records (EHRs). Some of the biggest challenges will be with security, interoperability, and issues resulting from clinician burnout.
Security
Safeguarding your EHRs means limiting access to the websites your staff can access. This may seem restrictive to your staff, but it’s a necessity. Your biggest concern is the installation of surveillance software or spyware on your system. Once this form of malware is installed on an individual´s device, every keystroke they make is logged and provides hackers with access to usernames and passwords that can result in a breach of Protected Health Information (PHI).
Controlling access to the Internet is an important aspect of HIPAA compliance. Restricting Internet access in hospitals and healthcare environments improves the security posture by adding an extra layer of defense against cyber attacks. The Department of Health and Human Services has issued guidance on ransomware. In the majority of EHR breaches, ransomware infections were involved.
Kris K. Wilson, chief information officer at Hilo Medical Center, a Hawaii hospital that received the top HIMSS Stage 7 ranking for its IT work reports that: “As EHRs mature and collect vast amounts of data, keeping this data safe as adept cybersecurity threats increase must remain at the forefront…Educating staff on the proper use of hospital systems and placing safeguards within your EHR to limit the amount of data accessible is a good start to overcoming this challenge.”
Internet access controls such as filters can help prevent your staff from visiting websites containing exploit kits that download ransomware such as Locky. An Internet filter works through a given set of guidelines that inform the filter about the type of web content a network user can access and what websites should be blocked. Lists of malicious websites (blacklists) can be loaded into the filter to provide immediate Internet controls.
When employed, Internet filters prevent recipients of phishing emails from reaching the target website – thus avoiding the potential infection of their device. The filter service will update these blacklists as new malicious websites are identified. However, it’s also important to know how to restrict Internet access manually to prevent exposure to inappropriate material. Your IT service provider can provide details on this.
Interoperability
As you know, your IT systems must be able to communicate with one another to properly manage patients’ EHRs. But as many hospitals, health systems, and doctors’ offices have found, this can be complicated.
David Ratto, MD, a pulmonary and critical care specialist and hospitalist at Methodist Hospital of Southern California states: “The major challenge that all of us face is the development of interoperability…Whether we are trying to accomplish meaningful use or improve the overall care of our patients, we need improved functional interoperability. Data must be available and needs to be seamlessly transferred from one source to the next.”
Dr. Ratto believes that we should scale back on Stage 3 Meaningful Use, but not with the interoperability segment. That is, “should not be pushed out to later dates, and in fact, it should be mandated that all vendor products meet interoperability standards.”
Mustafa Ozkaynak, assistant professor in the college of nursing at the University of Colorado Anschutz Medical Campus believes that “EHR systems should be open to accepting data from outside resources such as daily living settings and nursing homes…As more and more health-related activities take place in daily living settings – home, work, restaurants, etc. – EHRs should be able to use the data collected in daily living settings.” To address this challenge, he believes we must develop strategies for how this data can be integrated into their EHRs.
Clinician Burnout
Clinician burnout resulting from increased workloads to manage EHRs is an ongoing concern. Staff members become overwhelmed with the overwhelming requirements for maintaining and updating patient records. Technology experts should attempt to help clinicians do their jobs without tiresome and tedious technical work.
Matthew Ernst, director of training, documentation, and support for digital innovation and consumer experience at Thomas Jefferson University believes that “EHRs are great for gathering information into one tool, but the workflows to manage this are sometimes confusing and overwhelming for the staff, causing burnout…When staff get overwhelmed and start to feel burnout, their productivity goes down and possible patient safety issues can creep in.”
Plus, “Physicians spend too much time away from their patients and also continuing their work at home,” said Christine Sinsky, MD, AMA vice president of professional satisfaction. A study at the University of Wisconsin found that doctors spend 38 hours a month of their own personal time on documentation, with a peak on Saturday nights, Dr. Sinsky said. “I don’t know if that’s good for patients….I want my doctor to love her job.”
“Physicians often feel that their jobs have transformed from doctor to typist,” says Dr. Sinsky. “In a courtroom, we don’t expect the judge or the attorneys to do their professional work … and [simultaneously] create the legal record of the proceedings, but we have asked that of our physicians. [In addition], we’re asking for a near verbal recounting of every detail that happened—and that’s not humanly possible.”
To overcome this challenge requires a dedicated team of experts who can work with staff to help them maintain EHR workflows and devise shortcuts to make their work more manageable. “This team would partner with the staff, super-users, and designated department contacts, and would give the staff a sense of ownership into its use. The goal would be for the staff to become more proficient in its use and be freed for additional tasks” Ernst says.
The Answer? The Right Technology and Expert Assistance
Hospitals, health systems, and doctors’ offices must identify and understand that cybersecurity, complex technology processes, and increased workloads impose a hardship on their clinicians. The right technology, along with the assistance from IT experts who understand this will help ease these challenges. The right expert can also help with the selection, design, implementation, and optimization EHRs, and assist practitioners with EHR technology to promote the effective and efficient delivery of patient services.
Our team specializes in EHR migration and management. We’re familiar with the various solutions available today. We’ll help you and your staff use your EHR application correctly and efficiently so you won’t have to spend countless hours entering data. We’ll also make sure your systems “talk” to one another, and that they remain secure from today’s cyber threats.
