There has been a noticeable buzz in the Electronic Health Records (EHR) industry regarding a new technological frontier: Comprehensive Health Records (CHR). James Madara, CEO of the American Medical Association recently made the following statement: “We spend more than three trillion dollars a year on healthcare in America and generate more health data than ever before. Yet some of the most meaningful data — data to unlock potential improvements in patient outcomes — is fragmented, inaccessible or incomplete.”
Seen as the next logical phase for EHR technology, CHR encompasses patient data that comes from sources outside the EHR itself and constitute a range of different types of protected health information (PHI), such as social determinants.
Social determinants, as reported in a recent article by Healthcare IT News, include the following: “What people eat, how much they sleep, if they are obese or live in a food desert (or both), and whether they are lonely, because all of those factors can have an enormous impact on an individual’s health.” The future with CHR would incorporate other types of care such as community and social care into traditional healthcare.
The integration of these new types of data presents a few challenges. How will this data be collected, and from what kinds of devices? How can we make sure that the data is accessible and actionable while remaining protected and HIPAA-compliant? As EHR technology continues to evolve, advancements such as CHR and the Internet of Things (IoT) will have an enormous impact on healthcare, and it is important for the industry to evaluate all the possibilities that come with the evolution to CHR.
Increasing Interoperability For Comprehensive Health Records
Having access to new types of patient data in a patient’s health record will, without a doubt, have an immensely positive impact on the delivery of healthcare. The challenge, though, is integrating data that comes from different EHRs with these new and different sources of patient data.
The idea of CHR suggests a level of interoperability that at present is still in development. The AMA recently called for EHR software manufacturers and other healthcare stakeholders to take part in the creation of the Integrated Health Model Initiative (IHMI), which “supports a shared framework for organizing health data, with a focus on patient-centric information and finding those data elements most predictive of enhanced outcomes.”
Initiatives like the IHMI are a response to the increased push to expand the use of EHR technology and increase the quality of patient care. Some EHR companies favor open platforms with a more connected digital experience, which could provide physicians with the possibility of shared access to patient data over the internet, whether they have an EHR or not.
Once that data is accessible, though, it must come in a form that makes it actionable to healthcare providers. A Chief Product Officer at a major EHR manufacturer recently put it this way in an article for Healthcare IT News: “What we need more than anything is a platform that’s actually able to work atop all of that information. Just having it sitting there isn’t actually going to solve healthcare problems.”
Will the Internet of Things Drive the Transition to CHR?
One possible solution to the need for greater interoperability may come from an emerging technology that has generated widespread interest across many different industries: IoT. This technology is intended to collect and monitor data from essentially any internet-enabled device and store that data in the cloud. For healthcare, this could be what drives the next phase in interoperability and lead successfully to CHR.
In a sense, the IoT has already arrived in healthcare: there is already an established place in healthcare for the use of remote monitoring devices, wearable technology with smart sensors, activity trackers such as pedometers or heart rate monitors, glucose monitors, and smart beds. These technologies help doctors quantify their patient’s health data. Through monitoring their patients’ day-to-day lives, doctors can develop better healthcare plans.
A recent article from HITconsultant.net, titled “6 Reasons Why Healthcare Needs the Internet of Things (IoT),” describes it this way:
“What if the wearable device connected to a patient tells you when heart-rate is going haywire or if he has lagged behind in taking good care of himself and shared that information on other devices that you used while working? By updating personal health data of patients on the cloud and eliminating the need to feed it into the , IoT ensures that every tiny detail is taken into consideration to make the most advantageous decisions for patients. Moreover, it can be used as a medical adherence and home monitoring tool.”
Of course, even with IoT technology, EHR interoperability must be built-in, and therefore still requires a common platform such as the IHMI to provide shared access to patient data. Additionally, the IoT presents security-related concerns that must be addressed in the highly regulated healthcare industry.
Increased Security and Access Challenges That Come With IoT and CHR
As reported in the article mentioned above from HIT consultant, the greatest challenges in adopting IoT in healthcare are the following: data storage, management, and security. Reliability and security issues are a barrier because of “a lack of training and infrastructure among providers…even when data does flow freely, many providers lack the infrastructure and know-how to access it.”
In addition to keeping the data secure, there are key populations that are currently less equipped to receive the benefits of the IoT or CHR due to lack of healthcare resources in addition to an appalling internet connection. They include the elderly, rural residents and low-income populations. Ironically, these are the groups that need medical attention the most. Technological advances such as telemedicine have increased their access to healthcare, but much work remains to develop an infrastructure that can collect the wide range of data required to deliver CHR to them.
The Future of Electronic Health Records
There is no doubt that a transition will take place on some level that brings traditional EHR to a new standard. Whether the move to CHR comes decisively in the next few years, or as a step-by-step process of slow integration, remains to be seen. Given the emphasis on greater access to patient data, security and privacy-related questions arise, which must be resolved in a secure, fully compliant system.
The move to CHR will, in the end, be a great benefit to health care. As doctors gain greater insights into their patients’ health records, the possibility of providing higher quality care and saving more lives becomes a reality. It’s of the utmost importance to make sure that the transition is made in the most non-disruptive way possible to the delivery of healthcare.
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