Experts review storage concerns as meaningful use gets closer to reality

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Healthcare facilities will face numerous challenges prepping for meaningful use requirements in the coming years. On Thursday, a Web-broadcast seminar sponsored by Palo Alto, Calif.-based HP, entitled “Organizing Healthcare with Storage Visualization,” concentrated on some issues and current practices concerning IT storage in relation to the pending meaningful use requirements.

The presentation featured Dave Garets, president and CEO of Healthcare Information and Management Systems Society (HIMSS) Analytics, and Krishna Sankhavaram, MD, director of research information systems and technology department at the University of Texas M.D. Anderson Cancer Center in Houston, as the keynote speakers on the agenda.

Garets noted that the radiology PACS market is currently saturated with large and some medium-sized hospitals. Cardiology PACS, he reported, are being adopted at a slower rate.

The Chicago-Ill.-based nonprofit organization used its own HIMSS EMR Adoption Model (EMRAM), a seven-stage implementation model, to discuss the state of hospitals nationwide in congruence to how it believes the term meaningful use will be defined.

“There are approximately 26 stage 7, fully-implemented facilities in the United States,” Garets said. According to the graph provided in the broadcast, 0.5 percent of the nation’s hospitals are fully-implemented as of 2009’s third quarter.

Most hospitals are at Stage 3, including 40.4 percent of U.S. hospitals. The model showed that most hospitals in the United States were at or below Stage 3 of the EMRAM. The figure for Stage 2 implementation was 29.8 percent.

In a recently published white paper, HIMSS Analytics offered an overview of market gaps in relation to American Recovery and Reinvestment Act (ARRA) compliance. The society concluded that hospitals achieving Stage 3 of the EMRAM will be better positioned for the majority of upcoming 2011 requirements, if implemented across all inpatient nursing services.

Stage 3 includes the cumulative capabilities of clinical documentation, error checking capabilities in a clinical decision support system and PACS availablity outside of radiology, according to the document. 

“We’ve got a lot of work to do in this country,” stated Garets. “As technology gets better and better in the PACS world, you’re going to need enhanced storage.” In addition, according to Garets, ARRA requirements will drive storage utilization because hospitals will be sharing data with other healthcare facilities as well as patients.

Sankhavaram remarked on the challenges of automating health IT systems. “First thing that hits you is the huge amount of data,” he said.

M.D. Anderson is a cancer research center with over 75,000 patients per year. Their philosophy is to not move the data around, said Sankhavaram. He said its EMR is homegrown, where the data isn’t copied.

The cancer center's IT structure utilizes a three-tiered data environment where the first environment uses real-time data acquisition, the second houses data repositories and the third holds old data, online archives and backups.

Sankhavaram echoed Garets as he stated that storage demands will continue to increase. As that happens, he said, data sets from instruments will need to be more effective. Analysis will need large clusters, Sankhavaram stated, as well as “more reliable cheap disks”.

Garets expressed a concern that there will not be enough resources to keep up with the demands of meaningful use and ICD-10 requirements for the nation’s hospitals. In the question-and-answer session following the presentations, Garets illuminated that a shortage of manpower--by about 40,000-50,000--is another reason why it is important for hospitals to start planning as quickly as possible if they haven’t already done so.

“Vendors are going to be slammed, consulting firms will be slammed,” he stated. Because of this, hospitals might have to wait in line to stay afloat with measurements; a position where you could “risk missing deadlines.”

The final definition of meaningful use is yet to be determined. A proposed definition is expected by the end of the year, followed by a public comment period in early 2010.