EHR Current and Future Trends: What to Expect After the Pandemic

When implementing electronic health record solutions, every healthcare organization aims to optimize patient care, reduce medical errors, and facilitate coordination among healthcare providers. Unfortunately, as coronavirus cases soared, medical staff and researchers seemed to be unable to get the help they needed out of this system. Is EHR truly limited and not worth the investment? Or did the crisis simply expose some weaknesses, which can be adequately addressed in the future?  

A study conducted before the pandemic revealed the EHR global market was valued at $26,200 million in 2018. And it was expected to rise to $39,913 million by 2026 at a CAGR of 5.4%. This rapid growth was attributed to the introduction of AI into EHR systems. Will EHRs remain among the popular healthcare industry software solutions even after their flaws have been exposed?   

What Are EHRs?

An electronic Health Record (EHR) is an electronic collection of a patient’s medical history. An EHR is an official document shared among healthcare organizations. It makes secure health information available instantly to authorized parties. This is what a typical EHR system includes:

• Patient contact information
• Insurance information
• Allergies
• Chronic conditions and accidents 
• Medication lists 
• Hospitalization records
• Medical images 

Healthcare organizations started adopting EHRs long before the pandemic. This practice was initiated by the Health Information Technology for Economic and Clinical Health Act in 2009. By 2015, the majority of healthcare organizations were using some form of electronic records. According to the National Electronic Health Record Survey conducted in 2015, almost 87% of the physicians reported installing a basic EHR system.     

Due to the sensitive nature of EHR solutions, the government is attempting to regulate the quality of these systems. For example, the US government established the Medicare and Medicaid EHR Incentive Programs (now known as Promoting Interoperability Programs) to make sure healthcare facilities install EHR systems that correspond to the required standards.

Benefits EHR Bring to Clinics

Healthcare facilities use EHRs to access full patient history during appointments, predict illnesses and outbreaks, save costs, and eliminate errors stemming from manual entry.  

Improved Patient Care 

A US-based survey of doctors revealed that 75% of healthcare providers report that EHR systems enable them to deliver better patient care. 

During each appointment, physicians have access to the full history of medical records instead of just a snapshot of the patient’s state during the current visit. These electronic health record solutions are particularly useful in case of catastrophic events, when speed is crucial for diagnosing and treating ailments, and patients are frightened, confused, and unable to recollect all their critical healthcare details.   

“I can quickly and easily pull up test results in the exam room to review with my patients. I also can verify when they had past exams or procedures.”

• Sandhya Pruthi, MD at Mayo Clinic

EHR systems also enable the creation of patient portals, where patients have access to their own medical history and test results. They can also share notes with their physicians and exchange instant messages. 

Predictive Healthcare  

As patient data accumulates, more doctors utilize big data to predict illnesses and practice preventive care. Additionally, analyzing medical data from the population as a whole will help understand health trends and foresee potential outbreaks.  

Researchers at Atrius Health, Massachusetts, experimented with applying predictive tools to EHR and claims data to estimate the future rate of hospitalization for a diverse group of patients. With 185,388 participants, the research team was able to obtain a rather accurate individual risk score projecting the possibility of hospitalization during the coming six months.  

Increased Efficiency and Cost Savings

With the help of electronic medical record services, physicians can communicate with colleagues, pharmacies, test labs, and insurance providers in a fast and trackable manner. This eliminates the necessity of follow-up calls and the issue of losing communication records. 

Some healthcare records software providers produce systems with voice recognition capabilities enabling physicians to issue voice commands and receive answers without needing to physically interact with a screen. Concord Hospital, New Hampshire, adopted Cerner with Dragon Medical One (an EHR tool with voice recognition). Using this system, triage time dropped from 17 down to just 5 minutes for the monitored practice. Moreover, hospital transcription costs were cut by 90%.

When EHR solutions support billing and are connected to insurers, they can automatically review claims, spotting inconsistencies and eliminating errors, which increases first-time acceptance rates and speeds up the reimbursement process.  

Reduced Errors 

Storing patient records electronically reduces the risk of misplacement and eliminates manual data entry and subsequent errors. Furthermore, patient data in EHR systems is updated in real time, giving everyone involved access to up-to-date records instead of passing around a paper-based file.  

When it comes to medication, paper-based prescriptions can be lost or misread, causing errors in dosage. EHRs enable electronic prescriptions where doctors communicate directly with pharmacies, which reduces the possibility of an error.  

EHR During the Pandemic

Despite adopting basic EHR systems during the past decade, many hospitals were in the process of upgrading their EHR systems when the coronavirus struck. As a consequence, many healthcare organizations were forced to halt their EHR projects and dedicate their resources to battling the pandemic. Some are still hesitant to continue with their EHR initiatives. However, several US healthcare facilities are determined to complete their EHR systems despite the circumstances. One such organization is AdventHealth.

AdventHealth, based in Florida, kicked off its multimillion-dollar project of transitioning to Epic EHR in March 2020. This massive initiative spanned all AdventHealth care sites, which includes a network of 37 hospitals. This transition was initially scheduled to take three years. Currently, this project is at an early implementation stage, and the organization is making changes to adapt to the pandemic. For instance, it moved face-to-face training classes to a virtual format. AdventHealth continues to show flexibility, and the project remains on track.  

Examples of Successful EHR Adoption by Healthcare Organizations 

There are many examples of healthcare organizations that successfully employed EHR coupled with other healthcare tools to fight the pandemic.  

Scaling Up Virtual Visits During the Pandemic

Lee Health, based in Florida, set up a telehealth infrastructure back in 2014. However, when the amount of COVID-19 cases started to increase rapidly, this healthcare facility was looking to enhance its virtual care to cope with the crisis. This expansion project included:

• Employee screening to clear staff members for work every morning
• Remote monitoring of patients with mild symptoms 
• Connecting isolated COVID inpatients with their families
• Enabling quarantined physicians to monitor their patients

When looking for a solution, Lee Health opted for the Caregility UHE telehealth platform, which supports integration with the clinic’s Epic EHR and allowed Lee Health to roll out virtual visits in record time. The Epic EHR MyChart patient portal enabled physicians to safely initiate secure telehealth visits from within the patient records. These virtual visits became quite a successful form of care. In just one week, the sessions reached a count of 1,200 per day. 

Additionally, Lee Health supplied their inpatients with a telehealth-enabled device that allowed them to dial up their family members with one click. Being able to connect with loved ones eased patients’ struggle and isolation.    

Identifying Patients at Risk of Deteriorating Health 

Parkview Health, based in Ohio, is using the Epic EHR AI system to forecast which patients with COVID-19 are more likely to become critically ill. The Epic AI assigns every patient a risk score from 0 to 100. After thorough analyses, the doctors noticed that 75% of the patients who received a risk score between 38 and 55 did deteriorate and were transferred to a critical care unit.

Though such prediction systems usually take years to perfect, the urgency of the pandemic is forcing doctors to work under tight time constraints. As a result, Parkview Health has already started using this score to identify patients in need of close monitoring.

What’s Stopping EHR from Realizing Its Full Effectiveness? 

During the fast-paced pandemic development, clinical researchers have been desperately looking for a cure. Understandably, they turn to EHRs as a vast repository of data. These records document all the steps doctors took to treat a particular patient, and, if analyzed thoroughly, EHRs can indicate coronavirus trends. However, extracting data from hundreds of hospitals proved challenging as EHR systems built by rival technology companies contain their data in “silos.” 

“I’m stunned at EHR vendors’ inability to consistently pull data from their systems. It’s absolutely hampering our ability to understand and react to COVID.”  

• Dale Sanders, CTO at Health Catalyst

After tough negotiations between clinical researchers, the government, and technology manufacturers, a few vendors started to loosen their grip and granted researchers access to some COVID-19-related data. However, the problem persists, and changing behavior will take time. Janet Hamilton, the executive director of the Council of State and Territorial Epidemiologists, spoke about EHRs and the state of current data sharing:

“We’re using yesterday’s technology for the biggest public health emergency in our lifetimes. COVID has demonstrated for people what we’ve known all along. You can’t leave public health at the end of the line.”

In addition to exchanging data among EHR solutions manufactured by different technology vendors, there is also a problem of identifying the same patient across EHR systems, which can lead to creating multiple records for one individual. One possible solution to this problem could be assigning a unique patient identifier, but this unresolved issue has already been under discussion for over 20 years. Another plausible solution is biometrics. And again, its usage largely depends on the clinic’s location. For example, San Francisco issued a restriction on facial recognition in 2019.  

EHR Future Trends

Despite all the hindrances described above, EHR is still beneficial during the crisis. Devin Soelberg, Vice President of Business Development and Partnerships at Redox mentioned:

“We should first acknowledge that EHR architecture, despite its many flaws, is actually a huge asset during a pandemic or other widespread public health emergency. Organizations are able to track and report abnormal conditions much faster and with much higher fidelity than a paper-based system.”  

There are several directions and industry trends for EHR to follow. One, undoubtedly, relates to resolving interoperability issues. Another trend is about what exactly EHRs incorporate and how they are used.

Combating Interoperability Issues 

As mentioned above, current EHR systems struggle with interoperability and data integration issues. Even though there are attempts to enforce interoperability on a small scale, these efforts are unlikely to scale up any time soon. Not to mention that some EHR vendors, such as Epic, are attempting to keep health data within their systems. Some argue this move was made to strengthen their monopolistic hold on American health care, while Epic itself claims it fears poorly implemented smartphone apps might leak sensitive health information.  

It is clear that reasonable interoperability can only be achieved if hospitals and technology vendors work together, and the pandemic can certainly be the factor accelerating this process. 

Moving to Plan-based Records

Apart from improving interoperability, there are other EHR trends to follow. Harvard Business Review suggests moving EHRs from a record-centric system to a plan-centric system, meaning EHR systems will document what physicians want to happen with the patient in the future. 

Such EHRs will contain a customized health plan based on a patient’s preferences and conditions. For example, a patient who lives alone will have a different plan from a patient who has a similar disease but is supported by a large family. Health records will be shared with an assigned healthcare team. Every member will be able to see the patient’s health plan, view their own to-do list regarding this patient, and receive a reminder to alter the plan when the patient’s circumstances change.     

Final Thoughts

Your healthcare practice most likely already has some form of an EHR system in place. While there are issues, such as interoperability, which your clinic cannot resolve alone, there are still improvements that you can seek to increase your system’s usability and effectiveness. There is evidence suggesting EHRs can cause physician burnout. You can help your healthcare employees by augmenting your current EHR solution with AI technology to process the accumulated data and even assist in diagnosis in some cases. Furthermore, you can incorporate capabilities such as voice recognition and e-prescription, all of which will save time and make life easier for your employees.  

Author: Nadejda Alkhaldi, content writer at Softeq Development.

Company description: Softeq is a full-stack development company with offices in the US and Europe. It offers full-cycle engineering services, such as producing a comprehensive IoT ecosystem from scratch. Softeq client portfolio includes a wide range of organizations, from startups to Fortune 100. The company worked for Microsoft, Coca-Cola, Samsung, Verizon, and NVIDIA, among others. It is ranked in the Inc. 5000 fastest-growing private companies in the US for three consecutive years.