The electronic health record gets a bum rap. We blame it for increasing healthcare costs, poor clinical outcomes, and clinician burnout. While EHR vendors have some responsibility for all these adverse effects, they are not solely responsible. And remember that providers would not purchase EHRs that did not optimize revenue. So, when we realize that the EHR does not prioritize patient care but documentation for billing, we should not be surprised.
The EHR vendor’s focus on record-keeping led them to ignore the importance of building interoperability into their platforms. Conveniently, this lack of interoperability established high-switching costs, something any health system CFO can attest to. Unfortunately, patients received sub-optimal care due to the unavailability of a complete medical record for each treating clinician. Costs increased due to frequent duplication or unnecessary testing when previous results were unavailable.
The inability to exchange data among EHRs inhibits manageable clinical workflow that can effectively and efficiently deliver care. Currently, workflows need to be better defined to provide desired outcomes. They could be more consistent, less variable, and better integrated with the patient’s journey. Most EHRs, as currently configured, systematize these undesirable workflows and journeys. They are almost guaranteeing suboptimal outcomes. But this can change.
The federal Office of the National Coordinator for Healthcare IT identified interoperability as a significant objective several years ago. Its effort forced healthcare IT system vendors to revamp their code to support interoperability through APIs and embrace the FHIR standard.
Increased interoperability and patient and clinician desire to modify their use of existing healthcare IT tools offer IT leaders an opportunity to revamp their deployment of digital tools. In addition, new software powered by artificial intelligence and advanced analytics can advance these changes. It is time for a revolution in our use of healthcare IT, and the winds of change are finally at our back.
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