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.
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.