Health records have a rosy future: US report

Electronic health records (EHRs) are generally accepted by clinicians and hospital systems across the United States, a recent report by Booz Allen Hamilton has found. However it also found problems with existing systems in the way information is exchanged, and with patient engagement.

The report, What’s ahead for EHRs: Experts Weigh In, was generated from interviews with industry experts across the American health care and informatics communities. It concludes that EHRs are poised for significant innovation in the coming decade, potentially leading to higher quality and lower cost patient care.

The report says current problems with EHRs stem from the lack of information sharing between systems, meaning that patient data too often remains within the confines of the place it was generated, which makes an EHR system little more than a stand-alone “electronic filing cabinet”.

Other concerns about the uptake of EHRs include the high costs associated with implementing EHR systems in small practices and clinics, the volume of training time needed for staff to use a new EHR system (which are often not user-friendly), and the lack of patient-focused outcomes in many EHR systems built around practices and hospitals. The report says there is a need for government to create greater incentives for both providers and EHR system designers to facilitate the exchange of information between systems and work to improve cost and usability issues.

Developments in a few key areas provide the basis for industry experts expecting greater innovation with respect to EHRs. Chief among these are government policies such as the Patient Protection Affordable Care Act (2010) which encourage a move away from fee-for-service payment models and toward the rewarding of quality of care (one respondent went so far as to say “I think that curing cancer would have less of an impact on the US health care system than payment reform will have”).

The profit motive is the other main reason cited for likely EHR innovation in coming years. For instance the move by private insurers to diversify into service and care delivery is already fuelling new investment in EHRs, while new technologies to improve patient care such as mobile phone apps can have significant value added to them when integrated with information from EHRs.

Industry experts also expressed their aspiration for EHR systems to accommodate patient access in an “innovative, forward-thinking way” that improves the relationship between patient and clinician and sees the patient become more proactive about managing their health.