Jerry Buchanan, Program Manager and Scrum Master at eMids Technologies, Inc., an IT and BPO consulting company, listed five features that are missing from EHRs in a recent article in Healthcare IT News: Information, not data; comprehensive health history; information tailored for various users; tracking the transition of care; and patient-side management of information. Some of the features he highlights seemed so basic to me, it made me ask: If EHRs are not turning data into actionable information and holding comprehensive health history, what are they doing?
If we're talking about many EHR products not having all or some of these capabilities, I can buy it. There are next-generation EHR products out there that are offering some of these capabilities. I've talked with or heard many physicians and hospital executives whose offices and facilities have benefited from the clinical decision support derived from their EHRs and EMRs. They are getting alerts and actionable information, not just data dumps. Now I'm not saying there aren't products out there that are just aggregating data, but there are EHRs that are giving users information, not just data.
Comprehensive health history was another missing feature, although it seems like this should be standard in EHRs and EMRs. Perhaps this is partly a design flaw, and developers can make the system pull health history data from various sources. This could also be something that needs to be initiated by the physician office or hospital. Simply, the staff needs to get a comprehensive health history from the patient and input into the system early on.
Tracking the transition of care is a tricky one because it requires health information exchange, and the market is still a bit fragmented in terms of solutions. There are interfaces and integration tools and Web-based systems. The industry is still working these development issues through. To be able to deliver continuity of care, the participating facilities and offices need to be willing to work with one another. So while design and interpretation of data are things that software developers can control, tracking transition of care requires providers to cooperate with one another.
I would agree that information tailored for various users has not matured because the vendors have been focusing on the primary physician or nurse. I've heard about systems not being tailored for pharmacists and other specialists, but that's changing, as more users come on board.
Patient-side management of information is still an emerging area but one that vendors seem to be focused on. I would expect an uptick in patients being able to do this in the next couple of years, if not sooner.
I believe that as more hospitals reach the higher stages of the HIMSS Analytics EMR Adoption Model, they will have these "missing" features. With the federal incentives waiting in the wings, vendors are likely working on these features since they all speak to the meaningful use criteria.
