Electronic health records have the potential to improve the quality of healthcare, as they allow clinicians access to data analysis and patients to take an active role in their healthcare. However, obstacles encumber these technological portals, making it difficult to extract the good without the bad.
"Currently, the system relies heavily on alerts, which lead clinicians to develop alert fatigue."
Many of the hems and haws come from clinicians who are working longer days to input data into EHRs, which can be thankless efforts as patients may perceive doctors as distracted or negligent during appointments in which they must sit behind a computer. This is merely one example of how a flaw in the system can trickle down to interrupt interoperability and lower morale.
While many large and small practices that have deployed EHRs are already in tune with these inconveniences, a new report aimed at strengthening the system offers a closer look at them. As Modern Healthcare reported, the 11-page report prepared by 14 informaticists, "Report of the AMIA EHR 2020 Task Force on the Status and Future Direction of EHRs" pinpoints five problems and 10 resolutions regarding EHRs.
Here are the five pain points and accompanying suggestions underscored in the report.
- Documentation: Data entry can be burdensome for clinicians, and EHRs primarily place the responsibility of this task on their shoulders. Moreover, patients can play a role in data input, reducing the responsibility of the physician.
- Government regulation: Meaningful Use requirements should be clarified and simplified to promote interoperability, improve patient outcomes, streamline workloads and enhance usability of EHRs. Requirements should shift focus to technical guidelines, namely ones that promote interoperability, strengthen better quality measures and provide for secure care.The report suggests honing in on national priorities that are within the scope of a practice's specialties when it comes to inputting data.
- Increase transparency and streamline certification: Vendors should offer better insight to the EHR verification process whether it's through video recordings or some other method. Additionally, this data should be made available to the public.
- Foster innovation: Closed EHR systems make it difficult to conduct research that fuels innovation as it did in the past. The report calls for vendors to make EHRs more open to researchers and patients with standards-based application programming interfaces. Moreover, extracting longitudinal data from EHRs is complicated and expensive, which fetters national priorities because patients can't access their laboratory reports, clinic visits and radiology information from one system to another.
- Person-centered care delivery: To serve the patient fully, EHRs must evolve at a pace that keeps up with the culture of care delivery. This means that EHRs should stretch from just acute care to specialist care, laboratory, pharmacy, physical and behavioral therapies and long-term care. Not to mention, EHR data should also include a person's functional, social and environmental contexts, as they're key in a clinician's decision making. The report pointed out that although this information is pivotal, it can be challenging to access. Integrating additional platforms like smartphones, biometric sensor information, genomics and big data can bolster these efforts.
Additionally, the report explained that the interface and usability of EHRs in general need work. Currently, the system relies heavily on alerts, which leads clinicians to develop alert fatigue. This interrupts workflow and puts additional strain on practitioners.
Surely these changes won't happen overnight or independently. They require the cooperation of vendors, patients and clinicians. The report acknowledges this and in place of overarching goals, it offers healthcare an in-depth look at EHR benefits and shortcomings in hopes of inching closer to the nation's health goals. The report concluded that the problems are "soluble" and the future for EHRs is "bright."