By Sarah T. Corley, M.D., FACP, chief medical officer, NextGen Healthcare
The EHR has come a long way since its inception. Initially designed to electronically capture the patient visit, it has morphed into an integral tool for patient and provider communication as well as data management and analysis. Overall, this technology has been helpful in prompting healthcare organizations to shift away from paper and will continue to push the industry to a new era of care.
Looking forward, a comprehensive EHR can be so much more than a repository for patient health information. Organizations that fully leverage this tool can enhance their communication, support interoperability, drive proactive and collaborative care, and set themselves up for success with emerging initiatives, such as value-based care and precision medicine.
Taking Communication To The Next Level
Historically, healthcare has been static and siloed — there have been limited provider interactions with patients outside the care visit, and providers have treated patients relatively autonomously, working alone instead of collaborating with colleagues. However, the EHR is changing that. For example, patients can now use portals tied to the EHR to send secure messages to their physicians at any time, allowing them to get their questions answered without necessarily having to make an appointment. Likewise, the physician practice can use a portal to send appointment reminders and targeted education and other messages to a patient that sustains the individual’s focus on his or her health. Patients can even take care of administrative details electronically, such as scheduling appointments and refilling prescriptions, to more conveniently keep up with care. When taken together, all these opportunities for timely communication and smoother access can prevent care and treatment lapses and encourage better health management.
EHRs have also evolved to facilitate more robust interactions between providers. As systems become interoperable, providers are able to exchange secure messages about a patient, share patient summaries that outline current treatment and health history, send data to health information exchanges (HIEs) to enable detailed analytics, and communicate information regarding referrals. Not only does this ensure that all providers treating a patient are on the same page, it also reduces the likelihood of unnecessary and avoidable interventions. A recent review by the Agency for Healthcare Research and Quality (AHRQ) showed that by participating in an HIE, many organizations were able to reduce duplicate laboratory and radiology testing as well as limit hospital readmissions in certain situations.
Capturing And Analyzing Data
In addition to enhancing communication, EHRs are known for their ability to collect and organize large volumes of data. Physician practices can search their EHRs and identify patients with chronic conditions in need of care interventions such as annual tests, preventive therapies, and so on. Organizations can then use this information to transition chronic condition patients into care, helping them better manage their health and avoid acute problems that can put them at risk and be costly to treat. This is the first step toward comprehensive population health management. As systems advance, providers will be able to further tease out details from their patient populations to deliver evermore targeted and preemptive care through their EHR platforms.
Aside from the EHR itself, organizations that send data from the EHR to an HIE can also enable richer data analysis. For example, when a group of physician practices and surrounding hospitals all contribute data to an HIE, they have access to a more complete picture of the patient population and can dig deeper to uncover health trends that require attention. In fact, in a recent study, 89 percent found electronic data exchanges improve the patient's quality of care, showing the importance of housing data in the EHR and sharing it between settings.
Providers will always need a way to record and communicate about patient care. As such, the EHR will continue to underpin information exchange in the healthcare space. However, the specific role it plays will also grow, fostering greater communication and data analysis. For instance, consider a future where a patient portal does not just connect patients with one doctor, but all their physicians, regardless of whether they are in the same practice. Using data standards like FHIR, this may soon be a reality. Patients can then communicate easily with all of their doctors by logging on to one location.
These emerging data standards can also connect doctors more easily, allowing for even more integrated and responsive care. This will be essential as organizations pursue value-driven models that require high-levels of collaboration and risk management.
EHRs will also keep fueling population health management. As data analytics evolve, organizations will continue to zero in on their populations. Going one step further, as the world of precision medicine takes shape, there will be a need for a place to store patients’ genetic information so that providers can customize and finely tune treatment — and the EHR represents a logical choice. Organizations may also be able to leverage the patient portal to collect additional information about the patient’s genetic background, using questionnaires to identify patient characteristics to refine treatment.
It’s clear that the EHR is merely getting started on transforming healthcare. Just as it ushered the industry into the 21st century, it will continue to push providers to expand their communications and use of data. Although the technology itself may look different in time, the same fundamental principles will remain — holding the EHR at the center of patient care.
About The Author
Sarah T. Corley, M.D., FACP, is the chief medical officer at NextGen Healthcare. Follow her on Twitter at @sarahcorley.