Accenture built a “connected health maturity index,” analyzing a nation’s level of health information exchange among users along with their level of health IT adoption among specialists and primary care doctors. Adoption was defined across four HIT functions: administrative tools, electronic patient notes, electronic alerts/reminders, and computerized decision support systems.
Health information exchange was defined across seven connectivity dimensions: electronic communications, e-notifications, e-referrals, e-access to clinical data about patients who see a different provider, e-prescribing, and receipt of clinical results to populate patient EMRs and order requests.
The world leaders across these two dimensions are Denmark, New Zealand and Sweden where there’s nearly universal use by primary care doctors of EMRs. Spain and England, too, are more advanced than most.
The U.S. is in the middle of the pack, having gained momentum in the last two years motivated by the HITECH Act’s incentives for providers to adopt and meaningfully use electronic medical records.
Accenture defines “connected health” as healthcare delivery that leverages the systematic application of healthcare IT to facilitate the accessing and sharing of information, as well as subsequent analysis of health data across healthcare systems.
Connected health enables and encourages collaboration across stakeholders involved in peoples’ health.
Accenture identifies several key barriers on the journey to fully connected health:
– Systems and policies, which link IT investments to health outcomes, coupled with a lack of interoperability standards
– Organization and management, especially financial constraints on investing, poor collaboration, and unskilled project management
– Clinicians and end-users, including physician resistance
– Patients and the public, with respect to privacy and data security and health engagement activation.
Accenture points to three connected health stories among the nations explored: Kaiser Permanente’s MyHealth Manager patient portal; the Scotland’s Emergency Care Summary project which includes an electronic palliative care summary and mental health information; and, Hong Kong’s longitudinal health record for every patient which enables data mining that helps address population health.
Health Populi’s Hot Points: To move forward toward full-on connected health, Accenture identifies several paths. They all drive toward personalized health care that’s patient-centered: first, blend EMR systems with new methods of communication such as remote health management/telehealth and data analytics; second, redirect health interventions with lower-cost settings, especially those closer to the patient at home and via mobile; third, transforming the role of patients to enable them to manage their own care, most important for chronic disease; and fourth, explore the potential of enomics to personalize treatment and wellness plans.
Another report released this week from the National Partnership for Women & Families, Making IT Meaningful: How Consumers Value and Trust Health IT, emphasizes the patient-person’s role in this Connected Health Journey. The Partnership’s survey of 1,961 adults found that most people se value in EHRs, which the report syas is a “powerful seal of approval” for EHRs’ potential impact on health care.
Among those patients with online access, 80% use it. 12% of people use the systems 7 or more times a year, 26% use their EHR 3-6 times a year, and power users — at least once a month – number 10% of people with access to their EHR online.
This is the other side of the Accenture equation — that health citizens, at least in the U.S. as quantified by the Partnership, are ready, willing, and welcoming the prospect of embracing digital health data.
In tomorrow’s Health Populi, I will explore the privacy, security and trust findings of the Partnership’s survey, which add a sobering dimension to peoples’ embrace of personal health information online.