Over the past week I inquired from various groups as to their knowledge of EHR adoption. I chose the picture to the left because it represents "Fields of Opportunity" for EHR Adoption. From the responses to my question of EHR adoption, I received invaluable commentary from people across the nation (and globe). Key points addressed in their responses are paraphrased below. My commentary is in italics. New links have been added to the Healthcare & Technology Resource Page
A transition from "my patient" to "our patient" is a fundamental change in the way providers communicate as a result of EHRs.
EHRs can be a "living metaphor" for organizational transformation. There are issues beyond the technology (incentives, political and social concerns) that guides or inhibits change. Editorial note: I call this the "Three Ps" - People, Process and Platform that is the foundation for successful adoption of new technology in any organization. Additionally, adoption of an EHR system not only requires significant financial investment but also the commitment to improving the way healthcare is provided with access to patient records across facilities.
Although collaborative relationships exist, there is resistance to EHRs especially at a private practice level.
Information in an EHR should be presented not only in user-friendly ways but also with adherence to HIPPAA security authentication. Security of patient data is an important concern not only at the facility level but also for private practitioners.
Several responses commented that a #1 challenge for EHR/EMR adoption is the financial investment. This is further confounded by inadequate support offered by vendors to insure success and sustainability. A key gap for sustainability of an implemented solution is its supported interoperability and the need to adapt to changing regulatory reporting requirements.
I suggest that it is not enough that a facility has a clinical record and the physician has another, but that they need to "talk" to each other - essentially, provide a complete picture of the individual and his/her medical condition and treatments. In other industries this is called data exchange via interoperability.
The complete patient picture available at the right time, to the right people, is what can improve patient care if used effectively. That said, there is a significant (even greater) gap related to the investment to support changing regulatory requirements.
Finally, when there is no common language for reporting clinical aspects of a patient's condition, there exists an inherent difficulty in analyzing any information provided. Software vendors can't solve this problem, only people can. It's not about a physician's "chicken scratch" when it comes to understanding orders, it's about understanding the relevance and importance of clearly presented information - "just-in-time."
Check out the announcement that CCHIT is Launching a PHR Program for 2009 and will have information available for public comment on their site beginning September 29, 2008
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Link: Research teams unveil 'next-generation' personal health records.
