How EHR Priorities Have Shifted — and Why It Matters to Physicians

By Roland Therriault, President, InSync Healthcare Solutions
Twitter: @inSynchcs

What do physicians want in an EHR? If you asked doctors ten years ago, they would likely have listed many different features, applications or factors that shaped their technology purchases.

In 2010, CMS’ EHR Incentive program drove physicians to purchase technology that would help them demonstrate Stage 1 of “meaningful use.” Primarily focused on obtaining incentive payments, many physicians were less concerned about whether an EHR’s functionality aligned with collaborative care or easy access to patient data—a priority for today’s care environments.

As the industry turns the corner into 2020, increased focus on patient-centered care will necessitate that healthcare organizations consider what their patient care needs are today — and, more importantly, what they will be 10 years from now.

Research continues to suggest that EHRs in use today have room for improvement, which begs the question: What does the ideal EHR system look like today? By exploring industry trends and the ways physicians’ priorities have shifted, we can better grasp what is needed going forward.

Shifting Needs
When many physicians purchased their first EHRs, they were missing the proverbial crystal ball that could shed light into the rapid changes and developments that were coming for healthcare. Simply put, incentives reaching as much as $44,000 were top of mind, and providers were more concerned about deciding between cloud-based and on-premise EHRs than the role of interoperability in data sharing.

Healthcare priorities have continued to evolve and shift since that time. The industry has seen a surge in value-based care contracts and use of advanced technology — from EHRs and practice management systems to analytics solutions and telehealth programs. Interoperability is opening new doors to data sharing and communicating with stakeholders and patients, and the promise of artificial intelligence is top of mind for all stakeholders.

In another ten years, new manifestations of technology will likely emerge that are unimaginable today. And while physicians can’t totally predict the future, they can look to the past and extract some valuable wisdom.

Since 2010, physicians learned many EHR lessons the hard way, such as the danger of alert fatigue or the importance of having technology that streamlines documentation by eliminating the number of clicks needed. For example, if an EHR’s templates aren’t set up in a way that aligns with a physician’s workflow, documentation takes significantly longer than it should. Notably, a 2018 study by the Journal of American Medical Informatics Association (JAMIA) found that the longer a provider takes to document a patient visit, the greater the likelihood of error.

New Decade, New EHR
In June, the American Medical Association released guidelines for EHR vendors to prioritize going forward and provide truly patient-centered care.

At the top of the list are criteria that echo physicians’ real-life priorities: EHRs should enhance physician workflow, support care coordination and support team-based care. But that’s only the beginning of what physicians need.

The good news is that technological advancement is enabling healthcare organizations to extract greater value from their EHR investments than ever before. Here are some of the features that the ideal EHR will possess in the coming decade:

  1. Tailored workflows. EHRs made by large vendors are great, but physicians need systems that accommodate their real life — and are scaled to the needs of physicians, not just large hospital systems.
  2. Smarter alerts. The most effective EHRs are those with built-in capabilities that support physicians when they need it. Notifications are a big part of this equation. Physicians rely on medication or allergy alerts to ensure they don’t make critical mistakes. EHRs must be equipped with as few distracting clinical-decision support alerts as possible, so physicians aren’t just reading (and skipping over) important information when caring for patients.
  3. Specialty adaptions. Every medical group has its own clinical workflow. Consequently, an EHR that might be right for a primary-care provider isn’t necessarily right for a physical therapy practice or a behavioral health provider. Every specialty should seek out a vendor that understands its unique needs and has worked with similar practices that are willing to make a recommendation. In addition, providers should only work with vendors that understand how technology needs to support regulatory compliance.
  4. Flexibility. Healthcare regulations are fluid, even as patient care needs remain the same. Moving forward, healthcare providers need their vendors and EHRs to be flexible — for example, by featuring customizable interfaces that can be upgraded or modified as needed.
  5. Collaborative-care support. Healthcare organizations cannot exist in silos in the information age. Physicians and other providers must become more collaborative to align with the goals of value-based care, even if they’re not enrolled in an Accountable Care Organization (ACO) or similar partnership. The ideal EHR isn’t just interoperable per updated HL7 and/or other standards; it supports information sharing through the use of smart scheduling applications, push/pull clinical notifications and other features.

Physicians wish lists are always shifting. But having an EHR that supports today’s clinical and operational needs is the only want to provide consistently high-quality care.