2020 could have been electronic health records’ moment.
When COVID-19 hit the state of Washington and then New York City, a standardized and centralized database of aggregated patient data could have helped differentiate coronavirus symptoms from other conditions, hashed out high-risk patients and raised flags that a pandemic was imminent (and that this wasn’t just the seasonal flu).
Integrated apps could have quickly alerted patients with suspected cases of COVID-19 and instantly provided clear instructions walking them through what to do next.
Doctors could have collaborated across the country regarding new symptoms they’d observed and what treatments worked on different types of patients. Data modeling could have shown epidemiologists within days what it’s taken almost a year for us to understand about the spread of this virus.
An electronic health record (EHR) is a digital version of a patient’s paper chart, including medical history, diagnoses, appointment notes, treatments, immunization dates, labs and other important details.
Digital records make it easy to send data to specialists or new providers. Patients can engage with their EHRs and feel greater agency in their own well-being. Portability to emergency facilities can help providers deliver better-informed urgent care and pharmacies prevent deadly drug interactions.
In fact, 88% of surveyed providers report that their EHR produces clinical benefits for the practice and 75% say EHR allows them to deliver better patient care.
In theory, EHR should have revolutionized healthcare. Unfortunately, today’s EHR systems are built more for billing than for using dashboards to streamline patient evaluation or harnessing the power of data to forecast trends in the greater population.
No doubt the COVID-19 pandemic will inspire the next generation of EHR and how we leverage patient data. Consider these three key elements for building an EHR model that empowers patients and healthcare ecosystems to realize better outcomes — during pandemics and everyday well-being.
Prioritizing privacy & access
The recent interoperability ruling requires that EHR systems allow for standards-based exchange of health data via APIs. Patients are the priority here. Part of the Cures Act, the ruling supports patient access to their own health data and prohibits information blocking — keeping patients from seeing their own healthcare data.
Information blocking spells out a large part of the problem with current EHR systems and why records haven’t been able to function as a larger ecosystem. If providers aren’t allowing patients to see their own data, how are doctors and researchers supposed to appropriately access data in aggregate? Compliance deadlines with the interoperability ruling were recently delayed, but the ruling is a step in the right direction.
The solution isn’t to open health records and let the data flow. Instead, EHR vendors and innovators need to step back and reconsider the problems we need to solve — as patients, as providers, as a society.
What’s non-negotiable: EHR must protect patients’ privacy. Records need to be architected to preserve patients’ privacy while, at the same time, allowing for access to their own health data and enabling data to be used as part of aggregate data sets. Protecting patient privacy and streaming health data need not be mutually exclusive.
Data architecture for today’s challenges, tomorrow’s opportunities
Streaming data for testing, treatments, outcomes, case locations and other provider notes doesn’t need to put privacy at risk. But it can inform better patient care in real-time and research on the greater scale.
The next generation of EHR should provide balance and deliver the full promise of patient privacy and secure streaming data.
Both that balance and promise require a modern data architecture that can protect, stream and process data in response to patient, provider and societal needs — needs that we have today and those that we’ll realize we have in the future.
EHR vendors and innovators need to build flexibility into their data architecture and open the door for real-time analytics and product advancement. Flexibility is crucial for streaming data, AI and data modeling health systems could use to learn from one another, track trends and get ahead of them. As EHR products add on features, like voice commands, automation and chat, flexibility will be central to leveraging data and protecting it.
That flexibility can help a health system grow its own capabilities while contributing to the advancement of the greater healthcare ecosystem.
Continuous updates, continuous improvement
It used to be common for larger enterprise software packages to have annual and almost unwieldy software updates.
Downtime can cost lives when access to health data is cut off. Retraining after a major update could take months to complete — and challenges with bad usability and poorly customized systems can lead to provider frustration and increase likelihood that a provider will make mistakes.
Regular testing and continuous updates are common practice for modern product development and user-centered design practices. Many apps seamlessly update several times each month (Netflix updates automatically several times each day).
A product structure that allows for regular testing, feedback and seamless updates can keep an EHR system responsive to the health ecosystem’s evolving needs. Smaller, gradual improvements limit user confusion and can help nurture users toward interfaces that are more intuitive and less error prone.
2020 could be EHR vendors’ and innovators’ moment
Like other crises, the COVID-19 pandemic has revealed the gaps in our infrastructure and the opportunities in our future. How health systems and the healthcare IT industry respond will determine how we fare in the next health crisis and how we thrive with everyday well-being.