The field of sleep medicine is on the verge of a change that reflects opportunities for better data exchange and improved quality in clinical workflows. As electronic health records (EHR) systems are increasingly implemented nationwide, both opportunities and challenges emerge. The opportunities are attributable to recent nurturing strategies from federal healthcare strategies and the national sleep medicine quality guidelines.
The US has fallen behind Europe in the implementation of data management in healthcare, particularly with EHR implementation due to the fragmented structure of the healthcare system and barriers, such as privacy concerns between systems compounded by the lack of economic incentives for addressing integration and solving interoperability barriers. This fragmented care and orientation of incentives have likely contributed to the lower rankings in healthcare. In chronic disease management, the US ranks last relative to other industrialized countries.
The current explosion of capability in data gathering and exchange, along with the rollout of two acts: HITECH and PPACA have provided an engine for change and a near doubling of the use of EHR in office-based practices. Since the 2010 rollout, there have been broader outcome benefits, including improvement in patient satisfaction and provider adherence to standard care as well as a reversal of negative trends in uninsured patients and hospital readmissions.
The recent federal initiatives have resulted in dramatic increases in EHR products and development. In sleep medicine, AASM has complemented this by encouraging a more standardized approach with quality standards and leveraging of telemedicine and data management to improve quality and efficiency of care.
At the ground level, not all processing has been smooth. Change has an uncomfortable side, including unexpected outcomes, that must be managed. Preoccupation with electronic monitors may degrade patient communication and standardized templates may not reflect detailed data necessary to care. Integration of EHR must be complemented by methods for preserving data and communication that are requisite to excellent care.
Incorporation of dictated components of patient assessment and preservation of necessary face-to-face time with patients will need to balance virtual tools such as templates and online communications with patients. Encouraging healthy change in habits is the local work of local leadership and needs to be supported by change management strategies for innovation in data processing to be successful.
The purpose of leveraging data management is to improve care in sleep medicine. Empowerment by this new technology can improve quality by addressing shortfalls in provision of end-to-end care and patient-centered care by connecting patients and processes such as team coordination and automated data transfer. Efficiencies are created by virtual methods that improve access to care in sleep medicine.
The current national directions in healthcare including EHR optimization and integration are making early strides to improve some health outcomes. In sleep medicine, teaming these recently supported national initiatives with redesign of clinical pathways to leverage standardization and virtual methods can provide a better foundation for comprehensive care, end-to-end clinical pathways, and patient-centered care. In this process of change, we are creating new territories that will require self-examination and steering in addition to the commitment for better solutions.
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