The United States took a big step in the right direction when it enacted the Health Information Technology for Economic and Clinical Health Act back in 2009. Electronic health records (EHRs) were at the center of this legislation, and ever since, adoption has skyrocketed across the nation. Per the latest data available from the Office of the National Coordinator for Health Information Technology, 76 percent of nonfederal hospitals had implemented a basic EHR system in 2014 — eight times the number seen in 2008. What's more, 97 percent of these had a certified system in place.
While this is good news, it does not necessarily mean that the systems are being used properly, nor that healthcare practitioners are enjoying seamless experiences. Unfortunately, that side of the coin has been relatively negative across the board, as hospitals and other medical facilities struggle to standardize and optimize their EHR use.
One sign of this comes in the form of a warning from the American Medical Informatics Association (AMIA).
Failure to Launch
The AMIA published a letter it sent to the commissioner of the Food and Drug Administration (FDA) back in July that warned of the current setbacks in EHR use. According to the AMIA, the big concern is the lack of integrity in many systems — even those that are labeled "certified" — that makes them risky to use for clinical trials and research.
This is unfortunate given that EHR systems, as a whole, ought to be fueling dramatic improvements in large-scale medical research. Because of the lack of standardization and unwieldy legislative enforcement, the AMIA believes that the nation might not be ready to capitalize on these opportunities. Interoperability is also being viewed as a major issue that needs to be quelled before the FDA and other federal agencies can begin to gain useful, valuable insights from large-scale research through EHR systems.
This makes it clear that individual hospitals and practices are struggling to strike the right chords.
The Big Picture
Hospitals & Health Networks recently argued that the medical industry might need to reshape its approach to EHR use, specifically by working to get a more thorough vision of the future regarding its technology strategies. The news source brings up a good point, considering the speed with which the government demanded that medical facilities achieve meaningful use with EHR systems.
A very small portion of the country was using EHRs fewer than 10 years ago, and these incredibly complex systems require strategy, training, and time to master. There is not much practitioners and leaders in the sector can do about the regulatory-compliance aspect, but they can certainly put in the legwork to establish better plans.
Access, Analysis, and Personnel
Other research offers good insights regarding the ways in which healthcare facilities can speed up their timelines to achieve better use of EHR technology.
As EHR Intelligence reports, one large study of the most popular EHR systems revealed that most hospitals struggle to properly manage data access, data interpretation, and priorities following deployment. Access needs to be both secure and intuitive, so that EHRs remain private but allow authorized clinicians to find them with ease. Interpretation has been tricky because of a lack of structure and standardization, which should be a fleeting issue as systems mature.
The personnel side might be the easiest fix of all. According to EHR Intelligence, researchers believe that additional dedicated staff will help to ease the strain currently placed on healthcare practitioners.
"We posit that all organizations (not just those with "research" as part of their mission) should dedicate additional IT personnel and implement near real-time clinical data warehouses with easy-to-use report writing capabilities to support quality improvement and patient safety improvement efforts," the group told the news source. "This would allow current IT staff to focus on operational activities."
In addition to IT staffing, locum tenens practitioners can be invaluable when trying to get EHR systems under control. Hiring temporary staff dedicated to EHR support, or who can see patients while full-time physicians, advanced-practice clinicians, and others focus on paperwork and notes, will allow operations to continue running smoothly while the hospital or practice finds its footing with EHR technology.