In an effort to improve patient care and decrease healthcare costs, the Obama administration has earmarked $27 billion in grants to automate healthcare records and processes completely over the next several years.
One of the major challenges for potential grant recipients, which include hospitals, health information exchanges, integrated delivery networks and doctors in private practices, is the front-loaded qualification process under what is referred to as meaningful use.
The other major challenge comes once electronic health records (EHR) are actually ubiquitously available: integrating multiple file formats from various siloed information stacks, building APIs across disparate clinical and hospital information systems, securing personal data for HIPAA compliance and conversion from paper records to a portable electronic format.
An additional burden for healthcare practitioners and providers is the necessity of having to determine which of the many approaches now available from a plethora of consultants and IT solution providers will best suit their unique requirements.
The Hitachi Approach
Dave Wilson, Senior Director, Global Health & Life Sciences for Hitachi Data Systems (HDS), in one of his blog posts earlier this year poses the following question: “How can we manage metadata from all the different systems and provide better patient care?” According to Wilson, the answer lies in the creation of a metadata repository. “A metadata repository indexes all of the metadata from the different documents and information systems and consolidates the data into a single repository. From there, it integrates with the electronic health record to provide context around the metadata. Queries against a patient name will resolve all relevant data for that patient. By applying filters and algorithms against the metadata repository, the 'genius' EHR can then display the previously mentioned relevant patient data. We have just taken patient data and made it more relevant in the care of the patient.”
Wikibon’s CTO and co-founder, David Floyer, had this to say about the HDS approach: “Creating and managing metadata repositories are important components for improving enterprise data management and information exploitation. HDS has incorporated its leading-edge technologies into the Hitachi Clinical Repository to provide a much richer metadata capture by opening and interrogating every type of object (not just standard containers) during the acquisition process. This will give clinicians improved access to information related to the patient's situation and better decision making. HCR is a model for addressing the general data management challenges within IT of extending the value of data beyond the applications that create it.”
HCR in Practice
The Hitachi Clinical Repository (HCR) is available and working today. HCR’s foremost success story is one of the largest hospitals in Austria, Klinikum Wels-Grieskirchen, with more than 3,500 employees across 4 locations. KWG needed a way to make its complex and siloed processes more automated and efficient. The graphic below shows their infrastructure.
As Wilson notes, “Utilizing this metadata to make better clinical decisions will ultimately benefit patients and healthcare providers in the long run, but it is going to take some level of investment and development to realize the full benefits. Chronic disease management systems today are trying to accomplish similar results by tying together relevant data points. A metadata repository is the backbone of a knowledge management solution.”
At KWG, HDS has also paired their Hitachi Content Platform (HCP), a “virtualized distributed object store with advanced storage and data management capabilities that help IT organizations address a number of challenges posed by the ever-growing volume of unstructured data”, with the OpenText Livelink enterprise content management (ECM) solution which helps to capture and archive, among other things, SAP data.
A recent New York Times article points out that the challenges with adopting and utilizing EHR go far beyond the technological challenge. “This is a big social project, not just a technical endeavor,” says Dr. David Blumenthal, the Obama administration’s national coordinator for health information technology.
Moreover, a survey conducted by Health Affairs in August 2010 found that “while adoption of electronic health records (EHR) technology may be the mantra of hospital executives throughout the U.S., the reality is that only 2% meet the "meaningful use" criteria established by the U.S. Centers for Medicare and Medicaid Services (CMS).”
Meanwhile, with so much money at stake competition is expected to be stiff and well funded from the likes of HP, IBM, Oracle, and many others. Hitachi reports that it has more than 300 hospitals as clients, but most of those customers know it as a storage provider. And while the initial results from HCR are very promising, Hitachi will need to rely on its major healthcare solutions partners such as OpenText, Lawson Software, Hitachi Consulting and many others to make a significant impact on the U.S. healthcare market.
Hitachi Healthcare is working with Research in Motion (RIM), the makers of the Blackberry smart phone, to develop a “patient in your pocket” capability so that physicians and other care givers can have easy access to patient information. For those healthcare organizations using or considering SharePoint from Microsoft, Hitachi offers integration support to help “simplify implementation, improve performance, ease management and ensure your SharePoint environment is protected.”
Hitachi will also leverage its HDDS Discovery Suite, a multi-platform index, search and restore capability that enables “intelligent file tiering” as well as “proactive ediscovery and identification of content for compliance and governance” which allows for intelligent query. Hitachi has an HCR in-the-cloud offering on the horizon that will offer clients a secure, multi-tenanted operational model for those organizations that need additional technical expertise or are looking to lower capital expenditures.
Hitachi has a long history of delivering technology-driven solutions especially in the storage arena and providing the healthcare industry with an advanced clinical repository with a metadata management model as a core value proposition fits right into Hitachi’s primary area of competency. With key partnerships and internal resources in place and a focus on driving better patient care as opposed to just offering information life-cycle management as other infrastructure vendors often do, Hitachi will have to be considered as a viable option for any healthcare related entity looking to improve its information access capabilities.
Action Item: Healthcare administrators and CIOs looking for ways to comply with the Stage 1 meaningful use requirements in order to qualify for EHR dollars need to consider competent vendors with a healthcare focus who have the vision, in-house expertise and partnerships as well as the proven technology in place to help customers move their patient records infrastructures into the 21st century.