Nearly 10 years after the passage of legislation meant to spur health IT adoption, EHRs have undergone a rapid evolution.
This content is sponsored by Lenovo Health.
In 2016, an analysis by the ONC deemed EHR adoption "nearly universal" among acute care hospitals, with 96 percent of facilities live on the technology. A separate study, published in American Journal of Health-System Pharmacy in 2017, found 99.1 percent of hospitals had partially or completely implemented an EHR system in 2016, up from 33.6 percent in 2003.
It's safe to say EHR technology has fully permeated the U.S. acute care environment, constituting a win for meaningful use legislation. Whether physicians believe the technology has improved daily workflows and patient care, however, raises a separate issue.
As personal technology devices give clinicians increasing mobility in their everyday lives, their potential in streamlining hospital operations and coordinating patient care is clear to clinical stakeholders. As a result, many CIOs are interested in solutions that better suit clinicians' active workflow and help untether staff from desktop computers. Portable and secure endpoint devices — laptops, tablets and smartphones — enable clinicians to access medical charts anytime, anywhere to review patient data.
In the shift away from traditional acute care settings, an emphasis on mobility empowers hospitals to address physician satisfaction, accelerate care delivery and improve patient outcomes.
Today's EHR landscape leaves room for improvement
Adoption of EHRs nationwide is often attributed to the 2009 passage of the Health Information Technology for Economic and Clinical Health Act, a law aimed at promoting meaningful use of IT across the healthcare industry.
The legislation succeeded in encouraging hospitals to implement EHR technology, yet challenges remain. Although the majority of hospitals have implemented EHRs in the past decade, many IT systems have struggled to keep pace with the large — and diverse — amount of patient data continuously thrown at healthcare organizations.
"As greater importance is placed on care outside the hospital and as mobile technologies enable more advanced care [delivered] at a distance, the patient's data is likely to be sourced from many different environments, devices and care providers," says Wyatt Yelverton, a health solutions manager at technology company Lenovo.
"We have lots of data from everywhere — from clinicians, payers, regulators and, increasingly, from the patient," he adds. "The reality, though, is we're still learning how to manage so much information."
Mr. Yelverton says the rapid expansion of patient data has intrinsically shifted how physicians use EHR systems. "The proliferation of connected devices and expectations around interoperability are fundamentally changing the nature ofhow information is coming into our clinical systems. … It's alsoincreasing the complexity of our clinical decision-making," he explains.
For many hospital leaders, these evolving priorities strain their staff's relationship with technology. "In many instances, providers have found the EHRs they've adopted simply can't meet their needs," Mr. Yelverton says. "That pressure often leads to a decision to replace their legacy systems."
Rather than replacing legacy systems — which can cost organizations hundreds of millions of dollars — Mr. Yelverton offers hospital leaders a more cost-effective alternative: complement existing EHR investments with mobile endpoint devices, such as laptops, tablets and smartphones, that connect clinicians to patient data with increased flexibility. With more options for endpoints, a physician has 24/7 connectivity to relevant patient charts from within his or her pocket.
How to bring physicians 'anywhere connectivity'
A major demand from today's physicians is what Mr. Yelverton refers to as "anywhere connectivity," or a clinician's ability to access relevant patients' data regardless of his or her location.
In the consumer space, physicians have experienced the "miniaturization" of technology — and they're now bringing these expectations with them to the medical world. "The common everyday endpoint devices are becoming much more mobile-centric," Mr. Yelverton says. "We think about laptops becoming very, very thin and light, and what that means for physicians moving through different health environments."
This emerging focus on limitless connectivity hints at two interrelated health IT concerns: mobility and interoperability.
Clinical mobility refers to a physician's use of mobile devices to access patient data. For example, a physician might access a patient's EHR from a tablet at the bedside or view remote monitoring data of a post-operative patient through a smartphone, rather than only being able to access these systems on a desktop monitor. However, not all EHR systems offer associated apps or cloud connectivity.
Interoperability, by contrast, describes the ability for different IT and software systems — for example, an EHR and a remote patient monitoring solution — to exchange and use data. Interoperability is one of the greatest challenges and opportunities facing healthcare today. Driven in large part by poor interoperability standards across vendors, disparate systems today struggle to share information, hindering providers' ability to observe a full picture of patients' health.
Using technology systems that support both mobility and interoperability, a physician could access patient information from a variety of data sources anytime and anywhere to make care decisions. Yet today's physicians are often only able to view data held in their hospital's own EHR, which is accessed through a desktop computer.
How connectivity accelerates patient care delivery
Implementing secure mobile technology that offers physicians the opportunity to connect to patient charts as needed not only improves staff productivity, but also strengthens patient outcomes through earlier clinical interventions and better care management.
In recent years, physicians have voiced frustration with EHRs, citing the technology as detracting from face-to-face patient care. However, Mr. Yelverton suggests that with an enhanced focus on integration and mobility, EHRs will become a data management asset to practicing physicians. "The EHR is the expected point of confluence for all of those different data streams," he says.
These data streams span a range of patient interactions, especially as services such as telehealth, remote patient monitoring and home care continue to grow in popularity. For example, 59 percent of patients who used telemedicine in the past planned to increase their usage of remote visits throughout 2017, according to a July survey by the trade group Health Industry Distributors Association.
Incorporating data from various care settings informs physicians about their patients' care, particularly when managing patients with complex, chronic conditions. A physician looking to help his or her patient control hypertension, for instance, could monitor the patient's dietary, exercise and blood pressure data, among other variables, to customize targeted care plans and identify opportunities for intervention.
"Theoretically, the more information a provider has about a patient and his or her medical needs, the better we can provide care for that particular patient," Mr. Yelverton says. "[There's] a wealth of information that can more accurately inform chronic disease management, from resource allocation to how effectively we can deliver therapies personalized for the patient."
"But, we have to consider how the information in these platforms is made available to medical professionals and administrators," he adds.
The future: Endpoint devices provide a new frontier for EHR access
The majority of healthcare leaders — 60 percent — cited HER mobility as one of the top clinical capabilities they want from smartphones, according to a KLAS Research survey released in January. As physicians become increasingly mobile, conveniently accessing medical information on available technology has become paramount.
As an example of this technology, Mr. Yelverton pointed to Lenovo's Edge devices, a series of portable notebook computers and tablets.
"The principal focus in Edge devices is connectivity — always on, always connected," he says. However, for Mr. Yelverton, it's not just about making personal computers or laptops more portable but acknowledging phones and tablets are increasingly more capable — in some cases exceeding the computing capabilities of desktop devices.
For hospital leaders concerned with physician satisfaction, these growing demands reflect the blurring of lines between healthcare and consumer technology — an increasingly common occurrence, according to Mr. Yelverton.
"The elements that are significant for the endpoint devices in healthcare are also beginning to merge over into the consumer space as well, like commercial-grade security," he explains. "It begins to really blur the line between the devices that are built for healthcare and … those which a provider might use every day outside of the hospital."
Conclusion
EHR adoption across the U.S. has been staggering in recent years, with nearly 100 percent of providers live on the software. However, as physicians continue to voice frustrations with the lack of mobility on these IT solutions, hospital leaders must consider new ways to address staff satisfaction. Mobile endpoint devices offer one powerful solution by connecting physicians to patient charts through familiar technology — all at a moment's notice.