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Practice’s EMR Implementation Drove Up Costs For Six Months

Posted on September 28, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Everyone knows that providers incur EMR-related costs until well after it is implemented. According to a new study, in fact, one medical incurred higher costs for six months after its implementation.

The study, which appeared recently in The Journal of Bone & Joint Surgery, calculated the impact of an EMR implementation on labor costs and productivity at an outpatient orthopedic clinic. The researchers conducting the study used time-driven activity-based costing to estimate EMR-related expenses.

To conduct the study, the research team timed 143 patients prospectively throughout their clinic visit, both before implementation of the hospital system-wide EMR and then again at two months, six months and two years after the implementation.

The researchers found that after the first two months, total labor costs per patient had shot up from $36.88 to $46.04.

One reason for the higher costs was a growth in the amount of time attending surgeons spent per patient, which went up from 9.38 to 10.97 minutes, increasing surgeon cost from $21 to $27.01. In addition, certified medical assistants for spending what time assessing patients, with the time spent almost tripling from 3.42 to 9.1 minutes.

On top of all of this, providers were spending more than twice as much time documenting patient encounters as they had before, up to 7.6 minutes from 3.3 minutes prior to the implementation.

By the six-month mark, however, labor costs per patient had largely returned to their previous levels, settling at $38.75 compared with $36.88 prior to the installation, and expense which remain at the same level when calculated at two years after the EMR implementation.

However, providers were spending even more time documenting encounters than they had before the rolling, with time climbing to 8.43 minutes or roughly 5 minutes more than prior to the introduction of the EMR. Not only that, providers were spending less time interacting with patients, falling to 10.03 as compared with 14.65 minutes in the past.

Sadly, we might have been able to predict this outcome. Clearly, the clinic’s EMR implementation has burdened its providers and further minimized time the providers spend with their patients. This, unfortunately, is more of a rule than an exception.

So why did the ortho practice even bother? It’s hard to say. The study doesn’t say what the practice hoped to accomplish by putting the EMR in place, or whether it met those goals. Given that the system was still in place after two years one would hope that it was providing some form of value.

Truthfully, I’d much rather have learned about what the clinic actually got for its investment than how long it took to get everyone trained up and using it. To be fair, though, this data might have some relevance to the hospital systems that manage a broad spectrum of medical practices, and that’s worth something.

AI-Based Tech Could Speed Patient Documentation Process

Posted on August 27, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

A researcher with a Google AI team, Google Brain, has published a paper describing how AI could help physicians complete patient documentation more quickly. The author, software engineer Peter Lui, contends that AI technology can speed up patient documentation considerably by predicting its content.

On my initial reading of the paper, it wasn’t clear to me what advantage this has over pre-filling templates or even allowing physicians to cut-and-paste text from previous patient encounters. Still, judge for yourself as I outline what author Liu has to say, and by all means, check out the write-up.

In its introduction, the paper notes that physicians spend a great deal of time and energy entering patient notes into EHRs, a process which is not only taxing but also demoralizing for many physicians. Choosing from just one of countless data points underscoring this conclusion, Liu cites a 2016 study noting that physicians spend almost 2 hours of administrative work for every hour of patient contact.

However, it might be possible to reduce the number of hours doctors spend on this dreary task. Google Brain has been working on technologies which can speed up the process of documentation, including a new medical language modeling approach. Liu and his colleagues are also looking at how to represent an EHR’s mix of structured and unstructured text data.

The net of all of this? Google Brain has been able to create a set of systems which, by drawing on previous patient records can predict most of the content a physician will use next time they see that patient.

The heart of this effort is the MIMIC-III dataset, which contains the de-identified electronic health records of 39,597 patients from the ICU of a large tertiary care hospital. The dataset includes patient demographic data, medications, lab results, and notes written by providers. The system includes AI capabilities which are “trained” to predict the text physicians will use in their latest patient note.

In addition to making predictions, the Google Brain AI seems to have been able to pick out some forms of errors in existing notes, including patient ages and drug names, as well as providing autocorrect options for corrupted words.

By way of caveats, the paper warns that the research used only data generated within 24 hours of the current note content. Liu points out that while this may be a wide enough range of information for ICU notes, as things happen fast there, it would be better to draw on data representing larger windows of time for non-ICU patients. In addition, Liu concedes that it won’t always be possible to predict the content of notes even if the system has absorbed all existing documentation.

However, none of these problems are insurmountable, and Liu understandably describes these results as “encouraging,” but that’s also a way of conceding that this is only an experimental conclusion. In other words, these predictive capabilities are not a done deal by any means. That being said, it seems likely that his approach could be valuable.

I am left with at least one question, though. If the Google Brain technology can predict physician notes with great fidelity, how does that differ than having the physician cut-and-paste previous notes on their own?  I may be missing something here, because I’m not a software engineer, but I’d still like to know how these predictions improve on existing workarounds.

HPV Surveillance Project Reminds Us Why HIEs Still Matter

Posted on August 24, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

When healthcare organizations use EHR data to improve care or streamline processes, it seems like an obvious way to go. There are many benefits to doing so – certainly far more than I could cover in a single story—and odds of finding better ways to leverage such data further keep increasing over time.

Given the attention commercial EHR data use gets, it’s easy to forget the role of such data in improving public health. Yes, medical practices need to meet criteria that converge with public health objectives, such as managing diabetes and its side effects. And of course, population health management efforts directly mirror and sometimes overlap with public health goals. But it’s seldom the work of which rockstars are made.

However, given that the bulk of efforts have typically been spearheaded by government agencies or independent non-profits in the past, it’s a good idea to keep track of what they’re doing, especially if you’re wondering what else you can do with patient health data. It’s even more important to remember that even a cache of regional health data can be very valuable in supporting community health.

I was thinking about this recently when the following story turned up in my inbox.  On the surface, it’s not a big deal, but it’s the kind of cooperative effort that can improve community health in ways that work for everyone in healthcare.

This story looks at the kind of data harvesting exercise that flies under the radar of most providers. It describes an HPV surveillance effort, the HPV Vaccine Impact Monitoring Project (HPV-IMPACT), which is sponsored by the CDC and implemented by the Center for Community Health and Prevention at the University of Rochester.

The HPV-IMPACT project is relying in part on data by the Rochester RHIO, which is sharing anonymized patient health information collected between 2008 to 2014. The researchers are also using data from California, Connecticut, Oregon and Tennessee.

The goal of HPV-IMPACT is to identify trends such as changes in the percentage of women screened for HPV, the implications for different age groups and overall test outcomes. Once they complete this analysis, research will use it to determine whether HPV incidence rates can be attributed to vaccine use or alternatively, decreases in detection.

While this kind of project is bread-and-butter research, something that won’t ever make headlines in medical journals, it deserves some thought.

With things being as they are, it’s easy to dismiss HIEs as parts of a broken national interoperability effort. Hey, I’ve been as guilty of this as anyone. For many years, I waited for the HIE model today, in part because it just didn’t seem to be a sustainable business model, but at least some just kept on chuggin’.

As it turns out, regional HIEs aren’t abandonware — they just have their own niche. This kind of story reminds me that even limited health data collection efforts can make a difference. Keep up the good work, folks.

Physicians Lack IT Tools Needed For Value-Based Care

Posted on July 23, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

A new study sponsored by Quest Diagnostics has concluded that progress toward value-based care has slowed because physicians lack the IT tools they need.  In fact, the survey of health plan executives and physicians found that both groups see the progress of VBC as backsliding, with 67% reporting that the U.S. still has a fee-for-service system in place.

The study, which was conducted by Regina Corso Consulting, took place between April 26 and May 7 of 2018, included 451 respondents, 300 which for primary care physicians in private practice. The other 151 were health plan executives holding director-level positions.

More than half (57%) of health plan respondents said that a lack of tools is preventing doctors from moving ahead with VBC, compared with 45% last year. Also, 72% of physicians and health plan leaders said that doctors don’t have all the information they need about their patients to proceed with VBC.

A minority of doctors (39%) reported that EHRs provide all the data they need to care for the patients, though 86% said they could provide better care for patients if their EHR was interoperable with other technologies. Eighty-eight percent of physicians and health plan execs said that such data can provide insights that prescribing and claims data typically can’t.

All of the survey respondents agreed that making do with existing health IT tools is better than spending more. Fifty-three percent said that optimizing existing health information technology made sense, compared with 25% recommending investing in some new information technology and just 11% suggesting that large information technology infrastructure investments were a good idea.

Survey respondents said that a lack of interoperability between health IT systems with the biggest barrier to investing in new technology, followed by the perception that it would create more work while producing little or no benefit.

On the other hand, respondents named several technologies which could help speed VBC adoption. They include bioinformatics (73%), AI (68%), SMART app platform (65%), FHIR (64%), machine learning (64%), augmented reality (51%) and blockchain (47%). In its commentary, the report noted that SMART app platform use and FHIR might offer near-term benefits, as they allow companies to plug new technologies into existing platforms.

Bottom line, new ideas and technologies can make a difference. Eighty-nine percent off health plan execs and physicians said that healthcare organizations need to be more innovative and integrate more options and tools that support patient care.

Medical Practice Use Of Automated Claims Options Growing Slowly

Posted on June 25, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

A new study by a healthcare industry group has concluded that medical and dental practices are processing claims manually rather than going for full automation, a trend which is robbing the industry of very high levels of potential savings. While many physicians and dentists are using web portals to process claims, in most cases they haven’t reached the ”set it and forget it” level, a trend which could undercut possible savings.

The group, CAQH, tracks health plan and healthcare provider adoption of electronically-based administrative transactions for medical and dental practices. CAQH’s research estimates the time required for providers administrative transactions, including verifying a patient’s insurance coverage, sending and receiving payments, checking on the status of claims and handling prior authorization processes.

Its research concluded that despite the potential rewards, the medical and dental practices made only a modest level of progress in automating claims and related business processes over the past year. According to CAQH calculations, practices are still leaving roughly $11.1 billion in savings on the table, an estimate which has climbed by $1.8 billion over the prior year.

If these savings are realized, the majority ($9.5 billion) would end up in providers’ hands. However, many practices just haven’t gotten there yet.

A rise in portal use is certainly an improvement over paper-based claims processes. In fact, some of the increase in potential savings noted by the study is being created by a rise in online portal use.

However, providers’ adoption of fully-electronic claims is basically growing only a small amount or even declining for most transactions that can be done via a portal. For example, for prior authorizations, a big increase in portal use correlated with the decline in the adoption of fully-electronic transactions.

For CAQH, the endgame is getting all providers to automate claims processes complete, so the modest to flat growth in automated claims transactions is not exactly good news. In fact, it’s not a winning situation for medical practices either. According to the group’s estimates, each manual transaction costs practices $4.40 more than each electronic transaction and eats up five more minutes of provider time, which can create a real drag on profits.

Meanwhile, processing a single claim electronically through its lifecycle would save medical practices almost 40 minutes on average, and more than $15 in direct cost savings. Meanwhile, processing a single dental claim from start to finish could save dental practices almost 30 minutes on average and almost $11.75.

The CAQH press release doesn’t spell out what’s holding dentists and doctors back from automating the claims process completely, but it’s not hard to guess was going on. Unlike some providers, medical and dental practices typically don’t have deep pockets or large staff they can make this transition. If health plans want these providers to get on board, they’ll probably have to help them make the transition. However, even health plans haven’t invested in automated claims processing enough either.

Competition Heating Up For AI-Based Disease Management Players

Posted on May 21, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Working in collaboration with a company offering personal electrocardiograms to consumers, researchers with the Mayo Clinic have developed a technology that detects a dangerous heart arrhythmia. In so doing, the two are joining the race to improve disease management using AI technology, a contest which should pay the winner off handsomely.

At the recent Heart Rhythm Scientific Sessions conference, Mayo and vendor AliveCor shared research showing that by augmenting AI with deep neural networks, they can successfully identify patients with congenital Long QT Syndrome even if their ECG is normal. The results were accomplished by applying AI from lead one of a 12-lead ECG.

While Mayo needs no introduction, AliveCor might. While it started out selling a heart rhythm product available to consumers, AliveCor describes itself as an AI company. Its products include KardiaMobile and KardiaBand, which are designed to detect atrial fibrillation and normal sinus rhythms on the spot.

In their statement, the partners noted that as many as 50% of patients with genetically-confirmed LQTS have a normal QT interval on standard ECG. It’s important to recognize underlying LQTS, as such patients are at increased risk of arrhythmias and sudden cardiac death. They also note that that the inherited form affects 160,000 people in the US and causes 3,000 to 4,000 sudden deaths in children and young adults every year. So obviously, if this technology works as promised, it could be a big deal.

Aside from its medical value, what’s interesting about this announcement is that Mayo and AliveCor’s efforts seem to be part of a growing trend. For example, the FDA recently approved a product known as IDx-DR, the first AI technology capable of independently detecting diabetic retinopathy. The software can make basic recommendations without any physician involvement, which sounds pretty neat.

Before approving the software, the FDA reviewed data from parent company IDx, which performed a clinical study of 900 patients with diabetes across 10 primary care sites. The software accurately identified the presence of diabetic retinopathy 87.4% of the time and correctly identified those without the disease 89.5% of the time. I imagine an experienced ophthalmologist could beat that performance, but even virtuosos can’t get much higher than 90%.

And I shouldn’t forget the 1,000-ton presence of Google, which according to analyst firm CBInsights is making big bets that the future of healthcare will be structured data and AI. Among other things, Google is focusing on disease detection, including projects targeting diabetes, Parkinson’s disease and heart disease, among other conditions. (The research firm notes that Google has actually started a limited commercial rollout of its diabetes management program.)

I don’t know about you, but I find this stuff fascinating. Still, the AI future is still fuzzy. Clearly, it may do some great things for healthcare, but even Google is still the experimental stage. Don’t worry, though. If you’re following AI developments in healthcare you’ll have something new to read every day.

AI Software Detects Diabetic Retinopathy Without Physician Involvement

Posted on April 27, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

The FDA has approved parent company IDx to market IDx-DR, the first AI technology which can independently detect diabetic retinopathy. The software can make basic recommendations without any physician involvement.

Before approving the software, the FDA reviewed data from a clinical study of 900 patients with diabetes across 10 primary care sites. IDx-DR accurately identified the presence of diabetic retinopathy 87.4% of the time and accurately identified those without the disease 89.5% of the time. In other words, it’s not perfect but it’s clearly pretty close.

To use IDx-DR, providers upload digital images of a diabetic patient’s eyes taken with a retinal camera to the IDx cloud server. Once the image reaches the server, IDx-DR uses an AI algorithm to analyze the images, then tells the user whether the user has anything more than mild retinopathy.

If it finds significant retinopathy, the software suggests referring the patient to an eye care specialist for an in-depth diagnostic visit. On the other hand, if the software doesn’t detect retinopathy, it recommends a standard rescreen in 12 months.

Apparently, this is the first time the FDA has allowed a company to sell a device which screens and diagnoses patients without involving a specialist. We can expect further AI approvals by the FDA in the future, according to Commissioner Scott Gottlieb, MD. “Artificial Intelligence and Machine Learning hold enormous promise for the future of medicine,” Gottlieb tweeted. “The FDA is taking steps to promote innovation and support the use of artificial intelligence-based medical devices.”

The question this announcement must raise in the minds of some readers is “How far will this go?” Both for personal and clinical reasons, doctors are likely to worry about this sort of development. After all, putting aside any impact it may have on their career, they may be concerned that patient will get short-changed.

They probably don’t need to worry, though. According to an article in the MIT Technology Review, a recent research project done by Google Cloud suggests that AI won’t be replacing doctors anytime soon.

Jia Li, who leads research and development at Google Cloud, told a conference audience that while applying AI to radiology imaging might be a useful tool, it can automate only a small part of radiologists’ work. All it will be able to do is help doctors make better judgments and make the process more efficient, Li told conference attendees.

In other words, it seems likely that for the foreseeable future, tools like IDx-DR and its cousins will help doctors automate tasks they didn’t want to do anyway. With any luck, using them will both save time and improve diagnoses. Not at all scary, right?

EHR Usability Problems Linked To Potential Patient Harm

Posted on April 9, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

If you’re a clinician, you’ve probably always felt that EHR usability problems were a factor in some patient care glitches. Now, there’s some research backing up this hunch. While the numbers of EHR-specific events represented in the study are relatively low, its lead researcher said that it probably underestimated the problem by several orders of magnitude.

The study, which was profiled in the American Journal of Managed Care concluded, that at least some patient safety events were attributable to usability issues. The study, which was just published in JAMA, involved the analysis of nearly 2 million reported safety events taking place from 2013 to 2016 in 571 healthcare facilities in Pennsylvania. The data also included records from a large mid-Atlantic multi-hospital academic medical system.

Of the 1.735 million reports, 1,956 (0.11%) directly mentioned an EHR vendor or product. Also, 557 (0.03%) include language explicitly suggesting that usability concerns played a role in possible patient harm, AJMC reported.

Meanwhile, of the 557 events, 84% involved a situation where patients needed to be monitored to preclude harm, 14% of events potentially caused temporary harm, 1% potentially caused permanent harm and under 1% (2 cases), resulted in death.

The lead researcher on the study, Raj Ratwani, PhD, MA, told the AJMC that these issues are unlikely to resolve unless EHR vendors better understand how providers manage the rollout of their products.

Even if the vendor has done a good job with usability, he suggests, healthcare organizations adopting the platform sometimes make changes to the final configuration during their implementation of the product, something which could be undoing some of the smart usability choices and safety choices made by the vendor. “We really need to focus on the variability that’s occurring during the implementation and ensuring that vendors and providers are working together,” Ratwani said.

Along the way, it’s worth pointing out that the researchers themselves feel that the actual number of usability-related patient safety events could be far higher than the study would suggest.

Ratwani cautioned that he and his team took a “very, very conservative approach” to how they analyzed the patient safety reports. In fact, he suspects that since patient safety events are substantially underreported, the number of events related to poor usability is probably also very understated as well.

He also noted that while the study only included reports that explicitly mentioned the name of the vendor or product, clinicians usually don’t include such names when their writing up a safety report.

Physicians, Patients Intrigued By Digital Health Options

Posted on March 12, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

While digital health technologies have been available for many years, it’s taken a long time to get both doctors and patients comfortable with using them. However, the time is fast approaching, as the following study suggests.

New research from Ernst & Young has concluded that both physicians and consumers want to collaborate using digital technologies. The study found that consumers are comfortable reaching out to the doctors via digital channels and that physicians agree that digital technologies and data sharing can improve patient well-being.

More than half (54%) of consumers responding to the survey said they were comfortable contacting their doctor digitally. Also, they were interested in using technologies found outside of the physician’s office, including at-home diagnostic testing (36%), using a smartphone or connected device to share information (33%) and video consultations (21%).

Meanwhile, 83% of physicians told researchers that harvesting consumer and patient-generated data would make more personalized care plans possible and improve care quality. In addition, 66% said they felt increased use of digital technologies would make the healthcare system more efficient and lower costs, while 64% said it would help lower the burden on doctors and nurses, reducing the potential for burnout.

To make such cooperation practical, however, providers need to create incentives for data sharing, the E&Y researchers concluded.

When asked whether they were prepared to share lifestyle information with their physician, only 26% said yes. On the other hand, if doing so would allow them to reduce waiting times, 61% said they would share such data, if it would lower costs, 55% were interested. Also of note, 26% said they would be willing to share dietary and exercise information if they got tailored diet and exercise plans.

That being said, the level of interest in digital cooperation varied by demographics. Specifically, the survey found much lower levels of engagement and interest from consumers age 45 years and older, regardless of the form of technology discussed.

Still, both consumers and physicians seem to have a fair amount of optimism about the future of health. Sixty-four percent of consumers reported that they saw the US health industry as innovative, and 70% of physicians saw currently used technology as effective, both of which are high-water marks.

As this research points out, the gap between physician users of medical data and consumer portal users is narrowing by the day, but it’s still far from closed. It may take some time to figure out what incentives consumers find the most motivating. At the moment, it’s still a shot in the dark.

New Program Trains Physicians In Health Informatics Basics

Posted on January 18, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

A new program has emerged to help physicians make better use of the massive flow of health information they encounter on a day-to-day basis. With any luck, it will not only improve the skills of individual doctors but also seed institutions with clinicians who understand health IT in the practice of medicine.

The Indiana Training Program in Public and Population Health Informatics, which is supported by a five-year, $2.5 million award from the National Library of Medicine, focuses on public and population health issues. Launched in July 2017, it will support up to eight fellows annually.

The program is sponsored by Indiana University School of Medicine Richard M. Fairbanks School of Public Health at Indiana University-Purdue University Indianapolis and the Regenstrief Institute. Regenstrief, which is dedicated to healthcare quality improvement, supports healthcare research and works to bring scientific discoveries to bear on real-world problems.

For example, Regenstrief participates in the Healthcare Services Platform Consortium, which is addressing interoperability issues. There’s also the Regenstrief EHR Clinical Learning Platform, an AMA-backed program training medical student to cope with misidentified patient data, learn how different EHRs work and determine how to use them to coordinate care.

The Public and Population Health training, for its part, focuses on improving population health using advanced analytics, addressing public health problems such as opioid addiction, obesity and diabetes epidemics using health IT and supporting the implementation of ACOs.

According to Regenstrief, fellows who are accepted into the program will learn how to manage and analyze large data sets in healthcare public health organizations; use analytical methods to address population health management; translate basic and clinical research findings for use in population-based settings; creating health IT programs and tools for managing PHI; and using social and behavioral science approaches to solve PHI management problems.

Of course, training eight fellows per year is just a tiny drop in the bucket. Virtually all healthcare institutions need senior physician leaders to have some grasp of healthcare informatics or at least be capable of understanding data issues. Without having top clinical leaders who understand informatics principles, health data projects could end up at a standstill.

In addition, health systems need to train front-line IT staffers to better understand clinical issues — or hire them if necessary. That being said, finding healthcare data specialists is tricky at best, especially if you’re hoping to hire clinicians with this skill set.

Ultimately, it’s likely that health systems will need to train their own internal experts to lead health IT projects, ideally clinicians who have an aptitude for the subject. To do that, perhaps they can use the Regenstrief approach as a model.