Our past several columns have focused on the challenges presented by EHR technology, as viewed through the experience of our readers. The response to our request for feedback has been truly astounding, and in spite of an attempt to present a balanced perspective, there has certainly been a bias toward frustration with the current state of health IT.
But even with the challenges of today, we’ve always believed there are better days ahead. We constantly find ourselves asking: What will the future of EHRs look like, and how will the questions of today be answered by the innovations of tomorrow? Will the questions even still apply? As health care continues to evolve, will it lead the change in technology, or will advancements in technology shape the future of health care?
Recently, we had the opportunity to catch a glimpse of that future and find some answers to our questions, while attending a users’ conference presented by a major EHR vendor. As the company laid out its vision for tomorrow, several core themes were woven throughout it. We’ll attempt to highlight some of those here but will also offer this disclaimer: We left feeling encouraged overall by what we saw but certainly recognize that many might find their ideas challenging or even threatening to the way they practice. If the ideas below become reality – and it appears many already are – the landscape of medicine will be changed dramatically and hardly resemble the way it appears today. In other words, regardless of whether or not we are ready for it, change is coming and will redraw the map for the next generation of health care delivery. Here are some of the ways that will happen.
Patient engagement: Giving your patients the wheel
One of the most significant themes that ran through the conference was the idea of patient engagement. This has long been a "holy grail" in medicine, and one that seemed – at times – impossible to achieve. Any success was completely dependent on the talents of the physician and willingness of the patient, and no tools existed to help make it happen. That has completely changed. Enhancements to existing EHR software are finally putting patients at the very center of their care.
We have spoken before of web-based patient portals that allow patients to view labs and medication lists, but this is just the beginning. Now, vendors have created "apps" for iOS and Android devices, that completely integrate with the EHR. With these, patients are able to both view information and interact with their physicians in new ways. From a mobile device, a patient can now schedule an appointment, check in upon arriving at the office without interacting with the front desk, and even receive a text message when the doctor is ready to see them. They can also upload readings from connected devices, such as BP cuffs or glucometers, and see those data filter directly into the electronic medical record automatically.
Now we realize that some might see the EHR revolution as detrimental to the physician-patient relationship and accuse it of dehumanizing care. Throughout the last few months, we have received and repeatedly published those concerns. But there is no question that patients who are more engaged in their care have better overall outcomes and improved satisfaction. Also, the current generation of patients uses their smartphones for everything, eschewing paper and even their PCs for organization and communication. EHR vendors have decided to leverage this in an attempt to enhance care. For example, the new applications can remind patients about important health interventions (e.g., "You’re due for a mammogram."), and automate the process of communicating appointment reminders and health campaigns (e.g., "Get your flu shot now!").
Data: The new engine of progress
In almost every industry, information has become the currency of success. Headlines declaring that we are living in the era of "Big Data" assault us on all fronts, and health care is no exception. So many of our colleagues resent this idea, believing that the EHR has forced them to become glorified "data entry technicians." Adding to the frustration has been a limited ability to mine the data for salient information and manipulate it to improve outcomes and care outreach. But this is changing rapidly, and health IT vendors are finally placing a high priority on data collation tools to address these concerns. In response to changing trends in health policy, such as accountable care organizations and value-based care delivery, companies have developed tools that allow users to not only sort through their own data but also harness the power of a connected health network, and finally deliver on the promise of true population management and community health.