Early on, AIMed reported, in spite of the continuous improvement over the years, scientists at the University of Utah Health, Harvard University and Brigham and Women’s Hospital found that some electronic health record (EHR) systems are still unable to detect damaging drug interactions and other medical errors that could potentially injure or kill patients. Indeed, although EHR is adopted by 96% of the hospitals and 86% of physicians in the US, some believe it’s remains impotent when it comes to tackling challenges that the healthcare system faces every day. Its inefficacy is more obvious as the country battles against the COVID-19 pandemic.
John Glaser, Lecturer at the University of Pennsylvania’s Wharton School and former Chief Executive Officer (CEO) of Siemens Health Services suggests recently that the new generation of EHR should not stop at interoperability and usability. Instead, it should support and incentivize a brand new “value-based care business model of healthcare”. One which rewards providers who care about patients’ outcomes rather than “the volume of services” and shifts its attention from “reactive sick care to the proactive management of health”.
EHR needs to be dynamic
Presently, EHR is still; it is a record system that feeds on input and that’s it. It does not do anything to improve healthcare in general. As such, the new EHR ought to be dynamic. Patients seldom come to a medical facility with one single issue. The EHR is a “master plan”, containing all the information about the patients that will travel with them as they switch between providers or after services delivered by different sub-specialties. With that, the care team will be able to access how well patients are doing based on their previous interventions and provide suggestions on what to be done next and whether there are important lessons to learn from the plan which are also applicable to other patients within the population.
EHR needs to be intelligent
EHR was designed mainly for transaction and administrative purposes such as making appointments; retrieving lab results, transferring prescriptions to pharmacies and so on. Again, these functions are insufficient to address present challenges. The quality of data coming into the systems are not reassured and user interfaces are not intuitive enough to make entry and retrieval processes straightforward. Glaser proposes the EHR needs to be “intelligence-oriented”. It should be able to track each and every process and medication ever administered to patients.
At the same time, EHR has to ensure errors are spotted and corrected in time and providers can access any piece of information at ease so that new treatments can be discovered and unusual findings can be identified in advance. Glaser adds Kaiser Permanente, Intermountain Healthcare, Geisinger and UPMC have already built their EHR in such a way. However, these institutions do not just provide care but they also insure their patients, so they are somewhat “rewarded” for their ongoing “refinement and extensive use” of EHR.
EHR needs support
Glaser believes HER transformation should not begin from scratch. In fact, providers should take lessons from banking: absorbing an array of new technologies and capabilities and modifying them based on needs into a dynamic and intelligent system. Bear in mind that these new technologies to be adopted by the new EHR should encompass analytics that can turn large amount of health data into meaningful actionable insights. Artificial intelligence (AI) is also useful to spot abnormalities or bring out problems that providers failed to notice previously.
The new generation of EHR should also facilitate information exchanges. For example, physicians should be able to view medical history of patients arriving at the emergency room for a more complete clinical picture to conjure treatment plans. Ultimately, Glaser notes that transforming healthcare platforms required synergy. This does not limit to industrial cooperation but also between machines and human. EHR will not be intelligent without input from human experts or computational power. After all, we are not only talking about metamorphosing a record system but the entire healthcare system too.