Taking a Holistic View of Electronic Health Records
In my years of working with technology companies I have learned that even the best technology cannot overcome bad process. For technology to make an impact on healthcare efficiency and patient outcomes, computer systems must be interoperable, and must allow people to use data in a valuable way. These issues intersected recently, as reported in the Boston Globe, in an investigation that tied a patient’s death to an electronic health record (EHR) error.
The technical error was that the information for an insulin dosage was inconsistent between the electronic files and the paper charts. But, as Gabe Perna points out in his blog, “…the lawyer for the woman’s family is blaming the systems for not interacting with each other.” The lawyer claims the EHR and the paper chart should interact, or in tech terms, should be interoperable. This implies that the paper and the electronic chart should exchange information automatically. That cannot happen unless the information from the paper chart is put into electronic format. Interoperability is more than simply an exchange of information. Hospitals should always look for opportunities to streamline workflow (aka process).
There are two sides to every story, and this story is no different. Studies have shown the benefits EHRs and the data residing within them provide physicians, particularly on accessing patient charts remotely, helping to make good care decisions, and improving compliance with guideline-based care.
Jack Beaudoin’s article in Healthcare IT News, “Ending Debate on EMR Effectiveness?” points out the limitation of a recent study on EHRs and an effort to rework the data saying,
And the good news is, that study now exists and it has found that EMRs do have a measurable, positive impact on care as measured by clinical outcomes of risk-adjusted mortality rates.
He goes on to discuss a preliminary analysis to connect data from the HIMSS Analytics Database, and its comprehensive EMR adoption model (EMRAM), with Healthgrades’ own hospital performance database that measures hospitals on mortality and complication rates across multiple service lines.
“This effort is quite remarkable,” notes Lorren Pettit, vice president of market research at HIMSS Analytics. “By working together, we’ve been able to provide one of the most comprehensive and detailed analyses of the association between EMR capabilities and quality outcomes.”
Authors of a Health Affairs blog coined it well, “Patients, providers, payers, and vendors all have an interest in improving the usability of EHRs and integrating them into clinical workflows that produce better, more efficient care.”
I look forward to seeing organizations, like the American Academy of Family Physicians Center for Health Information Technology and Kaiser Permanente and Johns Hopkins Medicine move from implementation to collaboration and optimization of EHR technology.
Latest posts by Davida Dinerman (see all)
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