EMR Growth rate

This short article agrees with what I posted in a previous blog. The EMR is rapidly growing.
EMR market value was $15.7 billion in 2010 and its growth rate was 10% in 2009 and increased to 13.6% in 2010.
This can be considered, by all means, an astonishing growth rate. Yet, much less than what was previously expected.
The article predicts that the growth rate will rapidly increase in the nearby future.
http://www.fierceemr.com/story/emr-market-expected-increase-growth/2011-03-03

Health Information Technology - A Description of the Sector Landscape

The Health Information Technology Sector has many components. We are looking specifically at EMRs, Informatics, Analytics and Devices. By analyzing the current state and trends, we can predict what each of these pieces of the Health IT will look like five years down the road.

EMR

In the past, health data that is collected during care was recorded on paper. EMRs offer immense opportunities to improve patient care at the point of delivery by using this data and changing typical workflow. Adoption, however, has been slow because of barriers including cost, lack of expertise or technical knowledge and problems with interoperability.

With recent legislation, however, there is a major shift with financial incentives for healthcare organization that are able to attain “Meaningful Use”. There has also been a trend to address complicated reimbursement issues using data entered into the EMR. Many EMR companies have also, in an effort to improve efficiency in healthcare delivery, are offering mobile services.

In the next five years, we will see significantly better adoption of EMRs. EMR companies will compete on how their product address associated issues such as efficiency and reimbursement. In addition, EMR companies will begin using cloud services. Patient data will have the capability of be entered on mobile device, either by the patient or a provider. The reimbursement cycle will be sped up as hospitals have more information and use that as power over insurance companies.

Informatics

Clinical data includes data collected throughout the drug development lifecycle, starting with the R&D. This includes data about clinical trial management, pharmacovigilance both before and after drug launch and data in the hospital information systems. Historically, this data has been in paper form. Paper-based data collection has multiple pitfalls including the fact that it is extremely hard to correlate and make sense of data. There are also challenges for the FDA in terms of validating data and finalizing approvals.

One of the major shifts in the digital era has been the electronic information systems. Data today is collected from multiple sources and stored in data bases across the world. There are enough infrastructures, not just to store the humongous amount of data, but also to normalize the data and gain insights. With redundant systems making this data fail-safe, cloud infrastructures have enabled real-time access to data by all stake holders.

While aggregating and normalizing data from conventional sources including biopharma, CROs, providers and insurers pose challenges currently, the future could be defined in terms of a shift in patient control of data. Given the sensitivity of the data, it is only fair that the patient has enough control on both access of the data and data entry itself. For example, in order to minimize human intervention, chip implants in humans (which is already history) could gain more momentum in terms of personal health data governance and monitoring.

Analytics

Currently analytics are used to realize cost savings for medical payers. Predictive models are implemented by insurance providers to identify fraud and to estimate future costs for more accurate planning and risk reductions. The digitization of historical, present and future medical data is creating the availability of “Big Data.” Less than 20% of medical delivery practices are currently able to conduct clinical decision support.

In the next 5 years analytics will be a capability to enable clinical decision support to reduce medical costs associated with time, errors, and inventory. Cloud computing, mobile technologies and government regulation imply more data will be available and accessible anytime anywhere. These trends suggest that analytics may enable personal preventative health opportunities.

Conclusion

Overall, the industry will gain momentum in the next five years. Incentives for greater EMR adoption through the Affordable Care Act will spur adoption. Use of technology to increase privacy will improve informatics. Analytics will be used to drive decision-making, which has largely not been done in healthcare. All of these forces together will increase the influence of the healthcare information technology sector.

The Untimely Death of Google Health

This past summer Google announced that it would be retiring Google Health. This happened at a time when the healthcare industry is struggling with issues of interoperability and creating Electronic Health Records (EHR). Many medical centers, individual hospitals and ambulatory care centers are well on their way to implementing their own Electronic Medical Records (EMR) and meeting “Meaningful Use” criteria as established by the HITECH Act. Without Google, who is going to create an EHR?

First, let’s take a step back and clarify the difference between an EHR and an EMR. While the acronyms are often used interchangeable, there is a technical difference. An EMR is a digital version of clinical care data. It is a patient record generated by information collected at the point of care, either given by the patient (i.e. current medications, subjective complaints) or by diagnosis and treatments (i.e. radiologic tests, doctors’ observations). An EHR focuses on the total health of a patient, going outside of the treating healthcare organization. An EHR can be managed by clinicians and staff at more than one healthcare organization. Better yet, an EHR can be accessed and managed by the patient.

Having a comprehensive EHR would be very beneficial for patient care. Suppose you are a patient at Newton-Wellesley Hospital. You have a record there, so they know your medical history. You get in a car wreck in downtown Boston and are rushed to the nearest ER. Luckily it is Mass General. Like Newton-Wellesley, they are part of Partners Healthcare, so your EMR can be accessed. Now supposed you get in a car wreck in New York and are rushed to the nearest ER. They don’t know anything about you and because of HIPAA, Newton-Wellesley is very limited in the information they can tell the ER in New York. An EHR would solve this problem.

But who is going to create an EHR? Individual medical providers don’t have the incentive as they each as well on their way with their own EMR. Companies that design and sell EMRs don’t have the incentive to make their products interoperable because that allows competitors in. Regulators are unlikely to mandate a standard in our capitalist economy. Google was headed the right direction, but was unsuccessful. This is a two-sided network problem that is up for grabs now.

Personally, I don’t think we will ever have a completely interoperable EHR. We will have better transmission of data between EMRs in the next five years. I also think that many more people will carry around some sort of card/ bracelet/USB that allows their medical data to be uploaded into anyone’s EMR. While this is not reaching a status of EHR, it will increase probabilities of successful medical care for those who are specifically concerned or invested in their health. I think only a small portion of Americans would take an active step to carry their data with them, but for those who do, we will be able to increase quality and quantity of life.