Healthcare’s Silent Crisis: How Fragmented IT Systems Compromise Patient Care

/in , /by
Concept showing healthcare interoperability.
Innovative Medical Technology: A Doctor Interacting with Futuristic Health Data Visualization, Enhancing Patient Care

Healthcare’s Silent Crisis

Fragmented IT systems are compromising patient care.  In this era of digital transformation, healthcare stands at a crossroads. As technology evolves, the industry faces unprecedented opportunities to enhance patient care, streamline operations, lower costs, and improve outcomes.  But while technology promises to revolutionize patient care, a critical issue is lurking beneath the surface – the fragmentation of healthcare IT systems. This disconnection not only hampers operational efficiency but directly impacts the quality-of-care patients receive.

A recent article in Healthcare IT News, “Too many IT systems with limited alignment impacts care quality”  highlights the challenges healthcare organizations face when new IT systems are introduced without a plan for how they will impact other workflows and existing IT systems.  It should come as no surprise that in the 2024 Compass Survey from symplr, they find that 85% of clinicians say they lose more than an hour every day from administrative tasks.  Imagine how much better patient care could be if the right technology was in place.

But why is there a disconnect when it comes to healthcare interoperability?  Healthcare interoperability has been a hot topic since the early 2000s, but in 2004, President George W. Bush established the Office of the National Coordinator for Health Information Technology (ONC), which put a spotlight on the need to improve healthcare IT systems interoperability.  Then, the HITECH Act of 2009 further accelerated the adoption of electronic health records (EHRs) and further emphasized the importance of system interoperability, with HIMSS leading the charge with interoperability best practices.

Yet challenges still remain, and this continues to dominate conversations around healthcare IT.  Read on as we explore how interoperability impacts patient care and what can be done to improve it in the future.

The Current Landscape

Oracle wrote a great article in June 2024 that dives deep into interoperability.  They define Interoperability “as the capacity for each system on a network to communicate with other systems to share, consolidate, and use data. Interoperable applications and systems automatically exchange data in such a way that the data is accessible, accurate, and secure, with little human interaction needed. Interoperability is possible only when all stakeholders—healthcare organizations, governments, payers, and other players—agree on the standards, technologies, and terminology needed for the exchange of data between diverse systems.”

Interoperable healthcare data improves the patient experience and paves the way for better community and population health initiatives.  Today’s healthcare landscape is filled with numerous vendors that provide many different solutions all aimed at improving care. In fact, you would be surprised at the number of solutions deployed at most organizations.  Yet, without agreement on standards to exchange data, fragmentation will continue to cripple today’s workflows which hampers the effectiveness the solution is trying to solve.

Consequences of Fragmentation

One factor, Shadow IT, continues to be a growing concern.  Shadow IT refers to IT solutions purchased outside of a central IT’s domain. In essence, departmental purchases that attempt to fill a gap or need they believe is not being met.  The challenge of procuring solutions outside of central IT’s domain is ensuring proper due diligence is given and that solutions are 1) based on industry standards, 2) comply with current cybersecurity capabilities, and 3) proper data exchange/interoperability is available to ensure data is properly sent to the patient’s electronic health record.

Fragmentation of IT systems create their own set of challenges, like:

  • Duplication of data entry.  When systems are not interconnected, this leads to manual data entry multiple times, opening the door for data integrity issues due to data entry errors.
  • Wasting time.  Time is wasted when users must switch between systems to complete tasks.  This impedes workflow and can cause employee frustration, leading to burnout.
  • Administrative burden.  Anytime additional administrative tasks are introduced, employee frustration increases, and this can decrease workflow efficiency. It also takes time away from patient care, decreasing employee morale.  Removing administrative burdens is the key.
  • Incomplete patient records.  Siloed solutions create fragmented data which could be useful to caregivers.  Not having access to all patient data impacts care plans and may potentially impact overall patient outcomes.
  • Misdiagnosis or medication errors.  Not having interconnected systems potentially causes clinicians to misdiagnose a patient’s condition or prescribe the wrong medication. This can further complicate the patient’s condition, slowing recovery time, increasing costs, and impacting care.
  • Increased costs.  Fragmented systems increase overall costs due to all the factors mentioned in the previous bullet points.  It’s important to understand the full costs of implementing one-off systems, like multiple support contracts, duplication of data entry, lack of data exchange, and reduction in personnel productivity.

Integrated IT platforms, like those offered by InsiteOne helps address interoperability issues when it comes to PACS, RIS, and enterprise image archiving.  This simplifies data movement between the integrated systems and strict adherence to industry standards in data exchange. Information flows freely from InsiteOne to other connected 3rd party applications. 

Cybersecurity

Shadow IT solutions may provide a short-term fix, yet they can expose organizations to longer-term risk factors, namely cybersecurity challenges.

Since most healthcare systems have many IT solutions deployed, this increases risk to cybersecurity attacks.  The more IT systems that are deployed offers multiple entry points for cybercriminals to attack, making it increasingly difficult for IT to protect their domain. 

Further complicating this are the regulations that have evolved over the past few years around data exchange, interoperability, and cybersecurity.  Keeping up with these changes makes it challenging for some organizations to remain compliant. 

According to a recent article in Becker’s Health IT, many healthcare providers still using fragmented IT systems, there are inefficiencies and potential errors in patient care and billing. But upgrading systems comes with its own set of financial and operational challenges. 

The article goes on to further note that “The push for greater interoperability, driven by regulations like the CMS Interoperability and Patient Access final rule, requires health systems to modernize their technologies, often involving significant financial and operational investments,” said Ms. Cohen. “These fragmented systems create bottlenecks in patient information exchange and complicate the flow of the revenue cycle management data, further threatening the financial health of the organization.”

Reducing the number of IT vendors, while adhering to robust data and system governance, proactive compliance strategies and focusing on trust and transparency with data exchange will go a long way in improving healthcare interoperability and reducing risk.

Outlook

Industrywide initiatives in data standardization, adoption of those data exchange standards by vendors, and improvements in regulatory requirements will all play a part in improving healthcare interoperability.

AI also plays a role in the future of healthcare interoperability and data exchange. AI can help in areas like bridging the gap in data disparity and predictive analytics for patient care.  Finally, unified IT platforms help improve data exchange and reduce overall system burdens in healthcare systems making cybersecurity challenges easier to tackle.

The outlook for healthcare interoperability remains very positive and AI will most certainly have an impact on providing new solutions to old challenges. Yet continued diligence around data governance must remain a focus to ensure organizations are maximizing the value of the solutions they procure.

Conclusion

The healthcare industry must prioritize the integration and alignment of IT solutions to overcome the current fragmentation that currently exists. This integration effort should focus on creating seamless data exchange between disparate systems, standardizing data formats, and implementing robust security measures. By doing so, the true potential of digital health can lead to improved operational efficiency, enhanced patient care, and more resilient healthcare ecosystems. However, this transformation requires significant investment, stakeholder collaboration, and a commitment to overcome technical and organizational challenges. The long-term benefits, including reduced medical errors, streamlined workflows, and more personalized patient care, far outweighs any initial hurdles that may exist.

Want to learn more?  Give us a call or click here to start a conversation with one of our experienced team members today. 

If you’re heading to RSNA24, consider scheduling some time to meet with us or simply stop by booth #1737 in the South Hall and let’s start a conversation!

Imaging’s Perfect Storm

/in , /by
Image shows a sailboat in stormy weather.

The New Normal

Recently, Radiology Business discussed the top seven challenges that are impacting radiology practices today, and this is setting up imaging’s perfect storm.  In the past 20+ years, imaging has witnessed some impressive changes (film to digital, Meaningful Use, improved workflow tools, and artificial intelligence (AI) – to name a few.  However, as impressive as those changes are, challenges still exist.  Reimbursements continue to decline, staffing shortages persist, new regulations continue to challenge imaging, and older IT solutions are not designed to improve today’s workload efficiencies.

The article above mentions seven primary challenges. They are declining reimbursement, organizational consolidation, an inadequate labor force, imaging appropriateness, staff burnout, turf wars between radiologists and other non-physicians, and a decrease in workflow efficiency. The question is, can technology help improve any of these challenges to help ward off a perfect storm in medical imaging?

Declining Reimbursements

Outdated reimbursement models make it more difficult for clinicians to provide quality care.  Legislation is continually discussed to target reimbursement reductions, and this ultimately can have an impact on patient care.  Even the public is strongly opposed to reducing reimbursements to physicians. 

Technology plays a crucial role in mitigating the impact of reduced reimbursements in radiology. Advanced software solutions, particularly those powered by AI, can significantly improve the efficiency and accuracy of medical coding and billing processes. Some of these AI-driven systems (like AI driven reporting from MD.ai), can analyze radiology reports, automatically assign the appropriate billing codes, and ensure compliance with ever-changing reimbursement rules. By reducing coding errors and optimizing claim submissions, healthcare providers can maximize their reimbursement rates and minimize claim denials.

Advanced Picture Archiving and Communication Systems (PACS) and Radiology Information Systems (RIS), like the solutions offered from InsiteOne can improve overall operational efficiency. streamline workflows and reduce turnaround times.  These improvements allow radiologists to handle higher study volumes without compromising quality. AI-assisted image analysis tools can prioritize worklists, flag critical findings, and even provide preliminary reads, enabling radiologists to focus on complex cases that require their expertise. This increased productivity can help offset the impact of reduced reimbursements by allowing practices to maintain or even increase their study volumes while controlling costs.

Organizational Consolidation

Mergers and acquisitions will continue, and healthcare is not immune.  One way for hospitals to remain competitive and offer better services is through acquisition.  However, this creates challenges for radiologists as it shrinks the pool of locations they can contract with independently.  Oftentimes, they may be forced to work for an organization as an employee, losing any benefit they had as an owner of their own practice.

Although technology will not stop mergers and acquisitions, it can help with integration of the organizations once merged.  Technology can facilitate consolidation by providing scalable and interoperable solutions. Cloud-based PACS and RIS solutions enable seamless integration of imaging data across multiple facilities, regardless of their geographic locations. With centralized storage, retrieval, and sharing of medical images and patient information, continuity of care for patients is assured as health systems merge or expand. Advanced data analytics tools can help identify operational inefficiencies, standardize best practices, and optimize resource allocation across their network. Moreover, teleradiology platforms enable radiologists to provide remote readings and consultations, effectively distributing workload and expertise across the entire health system.

Inadequate Labor Force

Labor refers both to technologist shortages as well as radiologist shortages.  When it comes to technology to address this, advanced RIS and PACS solutions that provide enhanced workflows around study prioritization, automation, and streamlining processes can allow staff to do more with less.

AI solutions can augment and streamline imaging workflows. AI-powered algorithms can pre-screen large volumes of medical images, prioritizing urgent cases and flagging potential abnormalities for radiologists to review. This triage system allows radiologists to focus their expertise on complex cases, effectively increasing their productivity without compromising quality. AI can also assist in routine tasks such as measurements and comparisons with prior studies, reducing the time radiologists spend on these activities. Furthermore, clinical AI solutions can serve as a second pair of eyes, potentially catching subtle findings that might be overlooked during high-volume reading sessions. By handling time-consuming preliminary analyses and supporting decision-making processes, AI technology enables radiologists to manage larger caseloads efficiently, while not compromising care.  Additionally, AI used in screening scenarios can help sift through volumes of images and finding incidental findings, such as pulmonary embolisms, that can improve patient safety.

Imaging Appropriateness

The overuse of imaging, particularly by non-physicians, is a growing concern. This trend is driven by factors such as defensive medical practices, patient expectations, and the increasing availability of imaging technologies. Non-physician providers, often lack the specialized training of radiologists, and may resort to ordering unnecessary studies as a precautionary measure or due to uncertainty in clinical diagnosis. This not only contributes to rising healthcare costs but also exposes patients to unnecessary radiation and potential false positives, leading to further unnecessary interventions. The challenge lies in striking a balance between providing comprehensive care and avoiding the pitfalls of overutilization.

In emergency departments, overutilization of medical imaging stems from an intolerance for diagnostic uncertainty. Emergency physicians, also faced with time pressures and the potential for high-stakes medical decisions, may lean heavily on imaging studies to rule out serious conditions, even when clinical judgment might suggest otherwise. This surge in imaging requests, however, does not always align with the available resources in radiology departments, creating bottlenecks and potentially delaying critical care for those who truly need it. Technology, such as clinical decision support (CDS) solutions and integrated into electronic health records, can guide clinicians towards appropriate imaging choices based on evidence-based guidelines and patient-specific factors. Technology, along with better training for non-physician personnel, when implemented thoughtfully, has the potential to optimize imaging utilization, without compromising care and further straining radiology resources.

Staff Burnout

Most radiologists are reading beyond their daily capacity and this continuation can lead to burnout.  Increasing work hours, excessive study volumes, and the psychological strain associated with interpreting complex exams, can lead to feelings of exhaustion and dissatisfaction. Many radiologists find themselves overwhelmed by the pressures of their roles.

The constant influx of complex imaging studies, coupled with the need for rapid turnaround times, can further lead to mental and physical exhaustion. AI technology offers several promising solutions to alleviate burnout with image analysis, flagging potential abnormalities and prioritizing urgent cases. AI powered voice recognition software and automated reporting tools can significantly reduce the time spent on administrative tasks, freeing up radiologists to concentrate on image interpretation. Finally, workflow optimization systems can help balance workloads more effectively, ensuring a more manageable distribution of cases among team members.

Turf Wars

Increasingly, imaging studies being ordered – and in some instances interpreted by non-physician personnel can further strain today’s healthcare system.  This practice, often driven by the desire for quick diagnoses, insistence from the patient, or even financial incentives, can lead to misinterpretations, unnecessary follow-up studies, and potential patient harm. Radiologists, who have undergone years of specialized training, frequently find themselves in the position of having to review and correct these interpretations, adding an extra layer of work to their already demanding schedules. This situation not only increases the workload for radiologists but also creates tension between specialties.

The rift deepens when non-physicians insist on their interpretations or order inappropriate studies, forcing radiologists to navigate delicate professional relationships while ensuring patient safety. Moreover, this practice can lead to inefficient use of imaging resources, increased healthcare costs, and potential delays in accurate diagnoses for patients who truly need expert radiological assessment. As a result, many radiologists advocate for stricter guidelines and better education for non-physicians regarding appropriate imaging utilization and the importance of expert radiological.  Much of this will rely on health systems limiting or highly regulating the use of non-physicians participating in imaging studies or interpretations, as well as legislation that provides better education and guidance to make sure that non-physicians work harmoniously with practicing radiologists.

Improve Workflow Efficiency

Efficient workflow practices can make all the difference in the word when it comes to handling more work than one can physically manage.  If solutions help to streamline processes, often reducing manual intervention, interruptions, or outdated processes, and improve throughput in healthcare organizations.

Furthermore, radiologists spend about 36% of their time actually interpreting images, meaning the remainder of their time is spent consulting with other physicians and staff, struggling with outdated technology, continuously being hampered by administrative burdens that do not contribute to patient care, and other daily disruptions.  Implementing AI into workflows can improve efficiency, while paying attention to reading room ergonomics, can both go a long way in providing a better environment for radiologists to practice, while improving their overall mood, efficiency, and ultimately help reduce burnout.

Averting the Perfect Storm

Radiology is facing challenges from many fronts and attention must be given to help avert what is becoming a perfect storm that could negatively impact patient care in the future.  Health systems need to recognize the value that radiologists bring to the overall care of the patients they serve and focus on ensuring they have the right mix of tools, technology, and working conditions to allow them to manage the increasing patient study volumes they are experiencing.  Most health systems are using outdated technology, so the opportunity to modernize infrastructure and solutions with today’s newer, more efficient solutions is one path that can be taken to improve the situation radiology is facing.  Additional focus on reducing regulatory limitations, stopping constant payment reimbursements to radiologists, improve physician recruiting, remove administrative burdens, and provide increased job flexibility to help alleviate the challenges radiologists are facing today.

Consider InsiteOne for Modernization

InsiteOne has evolved with decades of experience as a vendor that that offers simplified to comprehensive workflow automation and storage solutions to the imaging industry, supporting many of the topics presented in this month’s blog.  By offering a modern, comprehensive suite of workflow solutions to meet your individual needs, InsiteOne is paving the way to help radiology practices make the impossible, possible.

Our cutting edge, cloud-native PACS, RIS and VNA are designed to optimize efficiency while improving overall radiology operations, all at a cost that works, regardless of the size of your organization.  Want to learn more?  Give us a call or click here to start a conversation with one of our experienced team members today. 

If you’re heading to RSNA24, consider scheduling some time to meet with us or simply stop by booth #1737 in the South Hall and let’s start a conversation!