Do your Electronic Health Records (EHRs) provide you with actionable healthcare patient insights? Why or why not?
We love data. Data represents the best means to ensuring a better patient journey. And, with EHRs capturing valuable patient data, the opportunity to put that data to valuable use is significant for improved outcomes. The challenge, though, depends on interoperability, so that EHR data can meld with other data to yield actionable insights.
Sounds simple, right? Sadly, it isn't.
Let's go through the strengths and shortcomings of EHRs to better understand how to gain better healthcare insights through interoperable applications.
The Strengths of EHRs
When it comes to data, it's critical to appreciate where we are. Before EHRs, all of that information resided in paper-based documents that were often difficult to read, interpret and absorb, not to mention challenging to share, access and refer to over time.
Accessible Health Records
According to The Benefits and Challenges of Electronic Health Records,
"Since EHRs are stored electronically, they can be accessed by different providers from different locations at different times. Providers are able to view the entirety of a patient’s medical history, track treatment plans, and more efficiently plan the course of care.
In a life-threatening event, the accessibility of Electronic Health Records can be lifesaving. By viewing a patient’s full medical history – allergies, blood type, past medical conditions — treatment decisions can be made quickly."
Better Communication & Better Care
As a result of EHRs, physicians and patients have the opportunity to communicate better.
Thanks to this digitally based medical record, physicians can collaborate over common patient information, tracking care and treatment decisions, and eliminating duplicate or unnecessary procedures.
For patients, EHRs offer an opportunity to become more actively engaged in their own medical records, have time to digest information and ask better questions of their physicians.
The end result is better care.
Fewer Medical Errors
Don't forget about improvements in medication errors. Electronic Health Records explains,
"In a review of EHR safety and usability, investigators found that the switch from paper records to EHRs led to decreases in medication errors, improved guideline adherence, and (after initial implementation) enhanced safety attitudes and job satisfaction among physicians..."
Electronic Health Records are undeniably an improvement over paper.
The Shortcomings of EHRs
Significant User Challenges
At the same time, EHRs offer significant challenges as the same article highlights:
"... However, the investigators found a number of problems as well. These included usability issues, such as poor information display, complicated screen sequences and navigation, and mismatch between user workflow in the EHR and clinical workflow. The latter problems resulted in interruptions and distraction, which can contribute to medical error.
Additional safety hazards included data entry errors created by the use of copy-forward, copy-and-paste, and electronic signatures, lack of clarity in sources and date of information presented, alert fatigue, and other usability problems that can contribute to error.
Similar findings were reported in a review of nurses' experiences with EHR use, which highlighted the altered workflow and communication patterns created by the implementation of EHRs."
You'll find plenty of articles online highlighting issues with EHRs, for example:
- 40% of Physicians See More EHR Challenges than Benefits
- 12 big EHR, patient record issues in 2019 so far
- 7 EHR usability, safety challenges—and how to overcome them
Not Intended to Provide Actionable Healthcare Insights
The point of this article isn't to bash EHRs, but rather to highlight opportunities to make them even more effective as they evolve.
According to The Electronic Health Record Problem, EHRs in their current iteration were never intended to provide actionable healthcare insights.
"In our current health system, EHRs have one critical performance requirement: generating clinical revenues. In the fee-for-service world, this means supporting providers’ billing and documentation to generate as much revenue as possible for each clinical service. EHRs also must help providers meet regulatory requirements that may have financial or accreditation implications.
This means that current EHRs were not created to support many of the things that physicians, patients, and policymakers value: better care experiences, reduced costs, or improved care quality and population health management. They were not created to make physicians better diagnosticians or more cost-effective prescribers. The reason: our health care system has mostly not rewarded these activities. They have not been mission-critical for providers or, therefore, EHR designers.
For that reason, EHRs have only the most minimal capabilities related to clinical decision support, which has been proven to increase the quality of care, or to the collection of information on duplicate and unnecessary testing, or on the aggregate health of providers’ patient populations."
Data Available for Novel Uses
That same article highlights the untapped potential of "a vast store of digital health data that are available for novel uses... Their value is increasingly understood by technology companies..."
Why technology companies?
"Systems need to be able to talk with one another to successfully gain the complete picture of a patient as possible... 'Data must be available and needs to be seamlessly transferred from one source to the next.'"
Many EHR systems have interoperability issues. If they can't be easily modified to play nicer with existing systems, then perhaps an outside technology solution can work in tandem.
Imagine, then, melding that vast store of data with clinical software solutions to orchestrate workflows in the OR and other hospital departments for better outcomes.
How Interoperability Between an EHR and a Clinical Software Solution Can Yield Healthcare Insights
Here's a hypothetical using TAGNOS.
As noted above, EHRs record care details. Superimpose on that real time data via RTLS to automate time and location data stamps. Automating means that you don't need staff to do so.
Use mobile communications to give front line clinicians and ancillary departments (like transport, housekeeping and biomed/clinical engineering) anticipated census data and case length, in addition to progress alerts of what’s going on and what’s needed in real-time – giving them the ability to go from reactive decision makers to proactive problem solvers.
Superimpose operational intelligence on that clinical collected data and deliver information that clinicians need to make in-the-moment decisions without having to comb through layers of incomplete, uncompiled data.
It's not about one system vs. another. Rather, it's about finding a way to make all of your systems as smart as they can be because they collaborate to benefit your patients' journeys.
Thanks for reading.
TAGNOS is the future of clinical automation software solutions with Artificial Intelligence. It is the only platform offering predictive analytics utilizing machine learning and RTLS. This groundbreaking platform leverages historical patient data continuously and adjusts operational intelligence to provide sustainable improvement to both the patient experience and metrics.
TAGNOS provides clinical systems integration, customizable reporting, dashboards, alerts, critical communication with staff and family to improve turnaround times. TAGNOS supports patient flow, workflow orchestration, and asset management.
In the course of 13 months, hospitals see a 12.7% reduction in its overall cycle time - saving an average of 40 minutes from each case and over $1.6M per year - more than 11x the typical investment.