Why are EHRs in Healthcare not Enough?
Healthcare records are a valuable resource for the healthcare industry because of the information they contain. The ones predominantly in use today are the electronic health records or EHRs. They are stored with, at the very least, lab results, diagnostic imaging results, and hospital visits. If a care provider's office is hooked into the regional EHR, then care provider visits will come up as well. If a hospital uses electronic charting, all of the records from a hospital visit (vital signs, blood sugar levels, assessments, etc.) will also be on it.
The EHRs were implemented to serve two primary purposes of giving easy access to patient medical records and keeping those records private. As more time passes with the majority of the population being on an EHR, data will become more and more meaningful to healthcare providers and patients. Their functionality can even go beyond that of just simple data storage. EHRs can even provide administrative office support and address physicians’ workflow needs by offering transcription services, mobile and tablet accessibility, and tailored specialty forms.
The challenges with using EHRs
Most hospitals have their own unique EHR databases that are set up to be accessible from every computer. However, every EHR format differs from one manufacturer to another, and the trouble is that not every format is readable on every system. In case, providers in different ACO networks need to exchange patient information for meaningful use; there are only so many ways they can get the files across.
Unfortunately, many people outrightly reject the practice of using EHRs because of the technical difficulties that might come with it. Most physicians and hospitals refuse to implement them, and complaints abound like high costs, weak interoperability, low functionality, safety and liability risks, etc. The success of an EHR implementation also depends on the locality of practice. For instance, it is much harder to connect to systems in rural sites within the same network! On top of that, functionality issues such as slow processing, user-hostile formats, and limited capabilities can further deter hospitals from using EHRs.
The inability of EHRs to communicate well with each other becomes a barrier to the transparent communication of health information that is essential for providing quality care. Poor interoperability not only prevents proper coordination of care on a small scale but also hinders PHM on a larger scale.
Optimizing the use of EHRs with health IT
Many would question the very idea of enabling interoperability in systems that are currently in use, hoping instead for universal standards to be made mandatory. However, that would lead to a complete overhaul of the systems. New EHRs will have to be implemented with the mandatory formats, which would result in more expenditure on the part of physicians and hospitals. A strategic yet, radical change like that would be slow to come by and perhaps will take its own sweet time to settle in with the rest of the industry that is still undecided upon EHRs in the first place. Therefore, in important matters such as those concerning the healthcare of millions, the best thing to do would be to exercise caution.
There is an old expression that is often repeated but seldom put into practice: ‘Make do.' It means that with whatever you have, make the highest and best use of it. To contextualize this adage in healthcare, it means that despite the struggles encountered with EHRs, we can achieve full connectivity for a transparent flow of information with the help of technology. For this reason, the role of health IT is significant for the optimization of EHRs in healthcare.
Health IT solutions can assist in leveraging the potential of EHRs to enhance patient care, improve productivity and reduce administrative costs. Interoperable EHRs can enable better workflows, and reduce ambiguities by allowing the transfer of information among systems and stakeholders of health care. With EHR interoperability, the ultimate goal, which is improving the delivery of healthcare, would be achieved. Healthcare will improve the quality of care by making the right data available at the right time to the right people.
Enabling interoperability in EHRs
For whatever reasons that may be, the U.S. healthcare failed to generate a market demand for robust interoperability from the start. Now, there is no time for “do-overs” but a dire need to retrofit interoperability into existing systems. Enabling a direct exchange of health data amongst providers instead of paper copies has the following benefits:
- Saves time - Real-time data exchange reduces the time-taken in the delivery of care thereby making the whole process faster and more efficient.
- Facilitates care coordination - Transparent flow of data makes it legible, clear and authorized for all providers.
- Cuts down risks - EHR systems that communicate well reduce the possibility of miscommunications which could lead to malpractice.
- Increases efficiency - Everything is electronically stored and does not need to be filled out over and over again.
- Avoids unnecessary tests - It reduces the chance of redundant testing and procedures by a large margin.
Over and above this, the meaningful exchange of patient health information relays accurate information to the care teams for a well-informed, coordinated and patient-centered care. Interoperable EHRs thus, play a crucial role in improving the cost, quality and patient experience of health care.
A sense of urgency is attached to making all EHR systems interoperable for effective communication amongst provider. That’s because, despite considerable investments in health IT, the advancement of electronic information sharing across systems has been slow. Something that is so fundamental to the success of EHRs has been left out of the center-stage of a value-based ecosystem for too long.
Concluding remarks
To realize their full potential, EHRs must be able to share information seamlessly and an interoperable health IT environment makes this possible. Interoperability will allow physicians and hospitals to share patient’s health records in real-time. Providers, patients, and insurers all benefit from increased access to patient’s health information.
For interoperability to gain wider prominence in healthcare, there needs to be a push from the policymakers and their encouragement will trickle down to the vendors and providers who will be more keen on making EHRs truly interoperable. The same kind of monetary incentive and promotion that fueled the adoption of EHRs needs to happen for interoperability to bring its importance into the limelight. The actual issue is rallying all the stakeholders of healthcare to form a consensus on the acceptance of interoperability for the better future of value-based healthcare.
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Vice President - Strategic Development at RM Healthcare Services LLC
7 年Awesome, as usual! I have become obsessed with the Subject now!
Healthcare Strategy and Operations
7 年Another great article Sandeep Gupta! One of the main troubles and complexities I see with a top down response to interoperability is that the providers do not all want the same thing in their EHR. It is very difficult to standardize the approach to EHRs when the providers are the ones truly behind the wheel. For example, the reason EPIC is so widely used is due to the providers truly loving the variance in the customization characteristics. They have the ability to chose precisely what they want at their standalone location/hospital/health system. This in turn creates an ever evolving complex environment to try and share a standardized set of data among providers (or with the health plans). To solve this problem of data exchange we need to think more outside the box. We at Health Data Vision Inc. our core competency is the business of capturing/retrieving EHR data. We took a unique approach to how we retrieve charts regardless of the EHRs being used. Every single EHR has the ability to print. So we developed a software that captures an image in the process of printing. Instead of trying to tie in/standardize on the back end of the EHR (like in an Apixio environment), we need to think broader because a standardized output from an EHR is not likely any time soon! Let's come up with a better solution! Last thought, if all the data is in the same format the risk is tremendous to predators. There is safety in variance! Food for thought and keep the great articles coming. Tom
Program Management Executive
7 年There are other issues beyond interoperability that drive dissatsfaction. These systems are complex and data hungry requiring physicians and clinicians to spend more and more of their time performing data entry. The very real perception is that they spend more time entering data, than focusing on patient care. The patient perspective supports this as a frequent complaint is that their doctor or nurse is more spends more time on the computer than talking to them. There is no argument that the intent and content that EHRs holds is invaluable. But the hurdles described in the article, as well as those I have described, must be addressed. Vendors need to focus on resolving those rather than adding more complexity with every new release.