By 2030, electronic health records will likely be more convenient, efficient, and intuitive for both consumers and clinicians.
Electronic health records (EHRs) first replaced paper medical records in the 1960s, and the technology has since progressed from punch cards, magnetic tape, and floppy discs to today’s cloud computing.1 The format of taking a patient’s medical history has also changed, from problem-oriented medical records to the more modern subjective, objective, assessment, and plan (SOAP) note.2 Despite this progress, the full potential of EHRs remains elusive for clinicians, consumers, health systems, and the health care system as a whole.
As the EHR market continues to consolidate, cloud adoption increases, and additional 21st Century Cures Act requirements go into effect later this year, health care organizations should be considering the future of EHRs. To better understand how EHRs should evolve to meet changing needs, the Deloitte Center for Health Solutions conducted a survey of 38 US-based College of Healthcare Information Management Executive (CHIME) members in the spring of 2022 and interviewed 13 EHR experts from 10 organizations including health care provider organizations, EHR companies, startup companies, and government agencies in the summer of 2022. The survey was designed to learn how EHRs can strive to:
- Achieve equitable health outcomes for all consumers with a focus on wellness and prevention,
- Enable clinicians to meaningfully connect with their patients and practice effectively and efficiently,
- Help health systems better serve their patient populations and communities while continuing to operate well financially, and
- Allow public health departments, researchers, and other stakeholders to access and use relevant data.
Our research found that many users want their EHRs to do more. Nineteen percent of the CHIME survey respondents were dissatisfied or very dissatisfied with their organization’s EHR system, with another 11% neither satisfied nor dissatisfied. Even respondents who were satisfied (70%) stated that aspects of their current EHR system wouldn’t be able to meet future needs. Interviewees noted that allowing clinicians to chart the way they want has always faced tension with the need for EHRs to satisfy other requirements (e.g., billing and regulatory reporting).
Read More About: Athena EHR
As we think about how EHRs should evolve out of necessity, it helps to understand what health care might look like in the next decade. Deloitte’s vision for the Future of HealthTM predicts that key drivers such as consumerism, data-sharing, and data interoperability will transform the health care industry by 2030. Consumers will seek out convenience and will be more focused on prevention and well-being. More advanced technologies will enable new capabilities. Are today’s EHRs prepared to help health systems meet this new future?
Health care organizations have realized the initial benefits of digitizing records, but health care leaders should prepare for the next generation of EHRs. Many of our interviewees felt that change is already underway, particularly with the opportunities that cloud native EHRs and a platform ecosystem approach can provide. Health systems should think more holistically about EHRs within the context of their current digital technology investments and identify what capabilities could improve the experience for consumers and clinicians. They also should develop a plan to test new capabilities and workflows, potentially with health care and technology partners.
Convenient, consumer-centric EHR systems
Interviewees noted that health care consumers want both convenient access to health care and good relationships with their physicians. But if they had to choose one, they would choose convenience. To help address this, more than half of the survey respondents are interested in adopting tools that would improve the consumer experience by reducing the time and burden of accessing care. In fact, 61% of the respondents plan to invest in patient communication tools, such as telehealth and messaging capabilities, with their health care team over the next three to five years (figure 1). Online appointment scheduling and virtual registration are other consumer-specific capabilities that organizations are looking to invest in during this timeframe.
Read More About: AdvancedMD EHR
To address some of these pain points, Geisinger Health System is streamlining its patient registration process using biometrics.7 Patient wait times are shorter because the patients are checked in faster and no longer required to share their date of birth, social security number, or medical record number at each appointment. This solution can also reduce the burden on front-office staff and reduce patient misidentification and fraud.8 Nearly 80% of patients who were offered facial biometrics chose to enroll in the program, demonstrating its appeal to consumers, likely due in part to consumers’ comfort level with similar technology on their smartphones.9
Unsurprisingly, interviewees noted that EHRs and patient portals are not intuitive enough, and improvements are needed for both clinicians and consumers. Clinicians in particular find documentation burdensome.10 While interviewees agreed that keyboard shortcuts and macros can help alleviate some of the data entry issues, broader changes should be made. Finding information is not always easy, and even if the capability is there, figuring out how to use it (e.g., sharing data and making it actionable) can be difficult.
Leveraging user experience design is important, but interviewees also touched on using human-centered design (HCD) and equity-centered design in the development of future EHRs (see sidebar, “Visualizing patient asthma history using HCD processes,” for more information.). That means designing EHRs with an understanding that not all end users are the same—even if they fit under the same persona category. It’s also important to recognize why different users are using the system (including researchers and administrators pulling reports for payers, regulators, public health agencies, etc.), invite a diverse set of users into the discussion from the beginning of the process, and provide more education and training on the EHR and some aspects of human- and equity-centered design.
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