The value of secure messaging is one that consumers have understood and enjoyed for years in areas outside of healthcare. Yet, its integration into healthcare has been bumpy, and the experience in southeast Tennessee provides one example why.
For hospitals such as Erlanger, sending and receiving such Direct messages as currently configured does not yet count this year toward the meaningful use Stage 2 requirement that hospitals provide a summary of care record using electronic transmission for more than 10% of transitions of care and referrals.
"One of the things we're having to evaluate is, is there a way to tie that into the electronic medical record capabilities to generate something out of the EMR through that protocol," Vamprine says.
"I'm not sure that forcing that work that the health coaches are doing through the EMR is really the best way to do that," she says. "Sometimes you can make a process less efficient by forcing it through a technology or a technology process that really doesn't meet workflow."
When a health coach is talking to a patient by phone and hears something, or is visiting the patient and sees something, and the coach needs to quickly send an email, Vamprine says it's not going to be most convenient to do that by logging into an electronic health record software system.
As for the Stage 2 requirement of doing such communications within Erlanger's Siemens-based EHR software, "the industry as a whole is reaching this bolus where we're driving all these meaningful use requirements and functionality with our EMRs and forcing people to do them, but it's creating a tremendous amount of work effort for the clinicians that is not conducive to efficiency in the workflow," Vamprine says. "It's creating additional work, slowing them down, and impacting their productivity, and increasing costs to the organization. I believe that's temporary, but temporary for how long depends on when can we move into the next phase of this and really begin to reap some of the benefit of what we're seeing."