Electronic heath records (EHRs) and other forms of health information technology have the potential to significantly improve care delivery and patient outcomes. But that can’t happen until the technology becomes more user-friendly and patient-focused than it is today.
That was the message delivered to physicians attending a session on the future of health IT during the 2017 American College of Physicians (ACP) conference in San Diego. Session speakers included Peter Basch, MD, MACP, senior director for health quality and safety at Washington, D.C.-based MedStar Health and outgoing chair of the ACP’s medical informatics committee, and Sachin J. Shah, MD a general internist and health services researcher at Massachusetts General Hospital in Boston.
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“The perception for many of us today is that technology is toxic,” Basch noted. “We cannot go forward with new care models and consistently provide high-quality, high-value care unless the act of providing regular routine care doesn’t seem like competing in the Olympics every day.”
The ideal EHR
Basch outlined his vision of what EHRs that truly help physicians improve their performance and deliver better care would look like. To start with, he said, most patient data entry would be performed by someone other than the physician, either a staff member or the patient themselves, via a patient portal.
Next, EHRs would provide information in a form that’s easily understandable to the patient as well as the physician. “The big advantage of EHRs over paper is what you can display on it,” he said. “It’s the ability to pull things together in different ways, to answer questions like, ‘how is the patient doing over time with this new therapy?’ It’s not something you can do as well on paper.”
Related to that is the need for EHRs to provide “accurate and actionable information,” especially in areas such as prescribing. EHRs rarely show what the final price of a medication will be to a patient, which makes it difficult for physicians to incorporate cost into prescribing decisions, he said.
A third element is what Basch called “anticipatory decision support”—providing EHRs with the ability to provide automatic help with ordering and treatment decisions based on a given stage ofthe patient visit. “We need EHRs that can anticipate our workflow. Something to remind us of things we forget when we’re multitasking,” he said.