It has been some time since Digital Health Space began publishing. Electronic health records are in use throughout all of health care. The process has been slow but inexorable. Let's take a look at where we are now.
The major vendors have outpaced many smaller companies, however, the smaller systems have found their own niche due to price constraints and the fact that many providers do not require very robust systems.
Large integrated health systems, including universities, and free-standing entities such as Mayo Clinic, Cleveland Clinic and others chose large robust systems. CMS directed vendor models equipped to extract important data for outcomes and cost containment. Interoperability became common using proprietary health information exchanges built into the vendor system or by using independent Health Information Exchanges.
In order to compete many smaller entities merged health information technology to gain financial ability to access these robust systems to compete favorably with large systems. In some cases, these mergers grew into complete new entities.
EHRs are no longer just a digital record. The EHR is credited with creating physician burnout as physicians became clerks inputting data, which took considerable time away from patient care. Data and analytics became essential using machine learning for predictive diagnosis
The addition of machine learning, natural language processing, and language processing are decreasing physician workload. Image recognition recognizes normal and sorts abnormal or questionable images to physicians for definitive diagnosis.
Explosive growth in telehealth occurred due to the Covid 19 pandemic, in 2020. Health payors reimbursed telehealth visits. Telehealth saved the day permitting distancing for most physician visits. Texting became routine for controlling patient flow and waiting room access. Podium and Sharp Health Care developed a texting system to improve patient communications. Caregivers are able to seamlessly connect with all patients, from those who have recently visited a care site for the first time or long term patients who have a deep relationship with their physician. With Podium’s Review & Feedback tools, care sites are able to automatically invite the customer to leave a review via text or the messaging app of their choice. Research shows that fast, and easy-to-complete review requests are ideal, and result in more accurate feedback. This integration will save caregivers’ time as well as increase the number and quality of their online reviews on Google, Facebook, Healthgrades and other key sites.
All of this allowed the merger of genomics, proteomics, and precision medicine using genetic engineering, CRISPR, and gene splicing. Over the counter DNA analysis became common, with varying success to study gene pools and personal Ancestry. The cost of these tests plummeted exponentially in the past ten years.
Not all is good, however:
Within six months of implementing a new EHR system at two urgent care clinics, clinicians' cognitive workloads more than doubled, according to a study published in Applied Ergonomics.
A news release on the study said researchers examined two urgent care clinics that are part of the Urbana, Ill.-based Carle Health Systems as they transitioned to new EHR systems.
Here are six key findings:
The increase in cognitive workload lasted for more than 30 months.
After two and a half years, the clinicians' cognitive workload remained very high, and the clinic's staff found the new EHR system more difficult than the previous hybrid system that used paper and computers.
Compared to nurses, clinicians reported greater increases in cognitive workload, including higher mental demands and levels of frustration.
Researchers said the data suggested that a portion of the increased cognitive workload resulted from having to use the new EHR system while they were with patients instead of after.
Minor design flaws like slow computer response times and the nonstandard labeling of tools negatively affected the users' perception of the system's usability.
At 30 months, negative usability ratings started to trend downwards. Researchers said the negative usability ratings may have gone back down to the rate they were before the new EHR was implemented if the study had gone on longer.
EPIC and CERNER have outpaced much of the HIT marketplace, favored by integrated health systems.
1. Small community hospitals have reported the highest satisfaction rates with EHR vendors Meditech's and Epic's platforms, according to a recent KLAS Research report.
2. Tower Health transitioned its remaining hospitals and facilities to the West Reading, Pa.-based health system's Epic EHR.
3. Newport (Wash.) Hospital and Health Services went live on a new shared Epic EHR system on March 13.
4. Epic announced plans for March 17 to open a COVID-19 vaccination clinic for its nearly 10,000 employees.
5. Buffalo, N.Y.-based Catholic Health credited its $135 million investment in Epic as a driving force behind its vaccination program, helping to distribute nearly 12,000 vaccinations to healthcare workers and others in New York's 1A category since late December.
6. Epic and health insurer Humana moved ahead with the next phase of their collaboration to improve patient and provider communication and access to health information. The companies will add support for automated prior authorizations and member insights at the point of care to their jointly developed prescription benefit tool IntelligentRx.
