EHRs and Healthcare Data - Amazon, Google, Microsoft, Salesforce and Apple

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Insights and Trends - Electronic Health Records (EHRs)

Most healthcare providers are in the process of converting patient notes and files into electronic health records (EHR), resulting in the development of several new trends. These include increased uptake of AI and voice recognition when creating and reviewing patient notes, increased efforts by healthcare providers to promote patient engagement with new portals, and increased demands by healthcare providers around the interoperability and integration issues of different EMR systems. The new technology has seen a trend towards a cloud-based infrastructure, while increased responsibility around personal data has seen a trend toward reviewing and upgrading cybersecurity among healthcare providers.

Greater Uptake of AI and Voice Recognition Technology in EHRs

  • Using AI to assist in diagnosing patients or to identify relevant aspects of a patients' history is well-known. Using AI and voice recognition in EHR is a relatively new but increasingly popular trend. More EHR companies are now incorporating this feature into EHR systems.
  • Allscripts and Northwell Health recently struck a deal for a platform that blends AI with EHR and collects data from clinicians. Using voice commands within patient care could be especially useful for providers who have their hands full.

Reason it is a Trend

  • The technology shows significant promise because of the time savings it creates. Healthcare providers are already overburdened. This system is helping to reduce the workload.
  • AI technology provides options for healthcare facilities to establish initiatives in population health, especially concerning chronic disease management. Population health often is forgotten due to time pressures. Things like AI initiated reminders, prompts, and collation of information can improve population health outcomes.
  • Medical professionals have recognized this is the first step toward increased use of AI in medical diagnostics. Upskilling and understanding the new technology is becoming vital.


  • Vanderbilt University Medical Center is a healthcare provider embracing this trend. Doctors, using voice recognition technology can ask the computer to complete a range of patient-related tasks.
  • AI technology searches the EHRs and communicates the results in verbal and written form. AI also highlights any abnormalities in the results. This technology is proving popular, efficient, and effective.

More Efforts to Increase Patient Engagement

  • Patient engagement accessing medical records, checking results, making appointments, and reviewing notes is slow progress. One of the primary reasons is historical. Patients still think this information needs to come from medical professionals.
  • There is evidence that as EHR uptake increases, the associated patient benefits increase. As a result, healthcare providers have become proactive and are encouraging patients to use the system.
  • Research is increasingly showing benefits to patients when they are engaged in their healthcare. Patient engagement through EHRs is one of the best ways to achieve this. Patient education in using the system will contribute to engagement levels.

Reason it is a Trend

  • A recent study showed, only 52% of patients access medical records through a patient portal when the service is available. This number increases when encouraged by their healthcare provider.
  • As patients become used to EHR, its use will increase. The savings offered to healthcare providers when patients use the system are significant, especially in relation to reducing manual administrative tasks for medical and administrative staff. There are also financial savings.
  • The savings to providers are significant, which is encouraging healthcare providers to encourage patient engagement. For example, one healthcare provider found when using the EHR to send appointment reminders to patients via text, the cancellation rated fell by around one third to 4%. The healthcare industry standard is 10.5%.


  • Oregon Eye Consultants looked for creative ways to encourage the use of the patient portal. Raising portal awareness and educating patients around use have had positive results. All bills include a note encouraging payment through the portal. Patient education fliers note that further information is available via the portal.
  • Reminders are provided by medical staff about using the portal each patient visit. Increasingly patients are adopting the technology.

Increasing Emphasis of Protection of Health information and Data Security

  • With healthcare providers adopting EHRs at increasing rates, the burden of keeping personal information safe will grow.
  • There is a trend toward placing a greater emphasis on cybersecurity to ensure that this information is kept safe. Healthcare providers will continue to develop and refine systems in this area.

Reason it is a Trend

  • Hackers are attempting to access healthcare records at increasing rates as more significant data is transferred to electronic records. As a result, the healthcare system has faced pressure.
  • Healthcare records are data-rich environments that are a target for hackers. A health record is worth ten times the value of a stolen credit card on the dark web.
  • There were 50,000 cyberattacks in 2017. The number of cyberattacks is estimated to be 300,000 in 2019. As more devices connect to the IoT, attacks of this nature are predicted to increase.
  • There were an average of 32,000 intrusion threats per day per healthcare organization in 2017. The average in other industries was 14,300.
  • Legal requirements around privacy and data storage require healthcare providers to address cybersecurity issues. The consequences of failing to do so have the potential to be life-threatening.


  • The importance of addressing this issue was illustrated by MedStar Health in Maryland. They were incapacitated due to a randomware attack. It became critical when patients' lives were placed at risk after they were forced to shut down the patient EHR database, and cancer patients did not receive treatments for several days.
  • The ongoing threat saw the Department of Health and Human Services release a four-volume publication in 2018. It addressed the threats and set best practice guidelines for healthcare providers.

Increased Demands for Integration and Interoperability

  • One much-lauded benefit of EHR was the ability for easy transfer of information between different healthcare providers, increased access to patient records across the health spectrum. To date, the level of integration and interoperability has been disappointing.
  • There is increasing demand from the healthcare industry for EHR software providers to address these issues, so the benefits of EHRs can be maximized.` With more providers adopting the technology, the issues around compatibility are becoming apparent.
  • The healthcare industry is placing an increased emphasis on the issue and demanding resolution. This is a primary issue around EHR. The trend is unlikely to slow until the issues have been resolved.

Reason it is a Trend

  • There is mounting concern at a government level, regarding the lack of interoperability. Recent statements by the Trump administration indicate the issue is on the government agenda. Comments made by the administration suggest regulation and noncompliance fines if the issue is not addressed.
  • There are serious issues in the integration of different EHR systems. This means the smooth transfer of information envisaged has not occurred. Medical professionals are inputting data manually to overcome the issues. This has created high levels of discord within the profession and demands for resolution.
  • The lack of integration is critical. The inability to transfer records and information between providers is a serious patient safety issue.


  • Ongoing issues around interoperability and integration saw the CMS overhaul the EHR Program. There is an onus on providers to address these issues with the software providers and developers to meet the compulsory certification requirements.
  • The issues around interoperability have seen it become a selling point with software providers that can guarantee integration with other EHR systems.
  • Elation Health is an example of a provider that has responded to the issues raised by providers and has proactively worked to resolve them. Consequently, it has become a selling point with interoperability guaranteed in their marketing material.

Cloud Technology for the Storage of EMR will be Adopted by Healthcare Providers

  • The transfer of EMR data from hospital data storage to cloud-based technology has gained momentum. Greater demand is placed on healthcare systems to secure and store the information.
  • The IT profession cannot meet the increasing demands of the healthcare industry associated with the increased adoption of EHR technology. This has resulted in healthcare providers looking for external solutions. A trend toward moving systems of this nature to the cloud has developed.

Reason it is a Trend

  • The increasing storage requirements related to EHRs is significant. The healthcare industry is also embracing other technological advances that optimize patient care. Current data storage levels are insufficient, and many providers cannot increase their current capacities.
  • The costs of maintaining IT infrastructure is draining on the resources of small and medium providers. Using the cloud is increasingly being seen as a cost-saving measure by several providers.
  • Reliability, accessibility, and security are three additional benefits of adopting cloud technology for the EHRs.
  • There is already considerable pressure on the IT industry to meet the growing needs of the healthcare industry. The increased demand due to the adoption of new technology means this situation is reaching a breaking point.
  • The healthcare industry needs permanent solutions to minimize any disruptions from a shortage of IT workers in the field. The logical solution is the adoption of cloud technologies.


  • Ellenville Regional Hospital was faced with the prospect of expenditure in the millions when implementing an EHR system. This was due in part to the inadequacies of the legacy system.
  • Facing increased storage requirements, increased licensing fees, and the need to upgrade computer systems to accommodate the EHR database, the cloud became the best option due to the increased capabilities it offered. The unique payment options and reduced software costs offered by cloud infrastructure were also persuasive factors.

Research Strategy

We extensively reviewed industry publications, media articles, and expert opinion to identify the trends in EHRs at the current time. After we had reviewed these sources, we were able to identify several key trends in EHRs. We reviewed each of these trends individually to ensure it met the criteria of a trend. The five trends we have identified all represent recent changes in this area. We have ensured there is hard data and facts to support the inclusion of each trend. These trends have also been identified in multiple different sources and by multiple commentators as trends in EHRs at the current time. Once we had determined the trends, we searched the aforementioned sources, for examples illustrating each trend.
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Case Studies - Healthcare Partnerships

The health care sector has seen a number of partnerships with several tech giants. Three of those partnerships are featured below.

Case # 1: Apple and Aetna Partnership

Case # 2: Apple/Department of Veterans Affairs Partnership

  • Apple and the Department of Veterans Affairs have joined forces. The goal of this partnership is to give veterans easier access to medical data.
  • Through the partnership, veterans will be able to access their health data from their iPhones. They will also have the ability to share their data with multiple doctors. Data that can be shared include lab results, immunizations, medications, and any data gathered from apps that track health.
  • So far, over 400 health systems signed up to work alongside the tech giant. In addition, all the hospitals and clinics that serve VAs have also signed on.
  • Apple has said that the initiative is the “first record-sharing platform of its kind” that is available to the Department of Veterans Affairs. Experts in health have said that the move is part of a push by the government "to open up access" to health data.

Case # 3: Microsoft and Humana Partnership

  • Microsoft and Humana have entered into a partnership to create health care services that are personalized and predictive. The partnership has the goal of making Humana's platforms modern by storing information in the cloud.
  • Secondly, it will aggregate data on health in the cloud, thus making way for advanced data analysis. Lastly, the union will create new services and products for the health care company.
  • Through this partnership, Humana's members will be provided with care teams empowered with access to information in real-time using Azure Cloud. Doctors will be able to deliver personalized health care by keeping track of customers' refills and medication schedules and providing a perspective on health's social barriers, that is, social isolation, food insecurity, and loneliness.
  • This is a seven-year partnership that commenced in 2019. According to Greg Moore of Microsoft, his company has a "tremendous opportunity" to have a handle on the impacting the increasing "demands on the health care system."
  • The spokesperson for Louisville Forward, Caitlin Bowling, said that the partnership between the companies is complementary to the one the city has with Microsoft. She is of the view that the partnership will "help us move towards the future."

Research Strategy

In conducting this case study analysis, we scanned the news for press releases on partnerships announced involving the healthcare sector and more specifically, EHR. We found several announcements of partnerships between companies such as Microsoft, Amazon, Apple, and Google with healthcare companies such as Aetna, Humana, and several others.

We shortlisted the cases that involved Amazon, Google, Microsoft, Salesforce, or Apple in partnership with a hospital, a healthcare company or the healthcare system. In each instance, we have presented the companies involved in the partnership, a description of the partnership and comments from key players.

However, it should be noted that in each case, the initiatives have not been implemented for a year as yet. As a result, there are no measurable success at this point. Nevertheless, we searched for information on each partner's website that would show any successes they have been experiencing. In the case of Apple, we found information on the app, including comments from users, however, there is no information or metrics measuring the success of the app or partnership. In the case of the Apple/VA and Microsoft/Humana partnerships, there is no information on the success of the partnership since it was launched. Furthermore, no mention has been made on the success of the partnerships with any of the company's annual reports. We believed company websites would be an excellent source of information as these brands were likely to put information on their website for the customers and investors to be aware of their achievements.

We also checked for press releases, however, we only found information on the announcement of the partnership, but no further news of the partnership. There is a website for the app, but the focus is on its features and the possibility for it to be downloaded. None of the partnerships have been mentioned in the news regarding successes. We believed the news would have been a good source of information for these partnerships as the initial news came as a press release, therefore we assumed any updates would have been made in the same way.

Social Media was another source we thought would contain relevant information. However, there was no new information on Attain or the Apple/Aetna partnership. In the case of Apple and the VA, the same information that was posted in early November is the latest information on the partnership. The same is true for the Microsoft and Humana partnership. We believed social media would have been a good source of information for these partnerships, especially on topics that are trending, however, these partnerships were only mentioned during the launch of the initiative and there have been no further posts from each of the players.

From the Apple/Aetna partnership, we have presented comments from the users to demonstrate the app's success from the customer's standpoint.