In this sixth post of the series on disruptive technology (see this link to start from beginning), I will present an overview of the capabilities and deficiencies of today's EHRs. In my next post, I will show how a novel whole product solution, consisting of EHR Companion Applications, can bridge the gaps that prevent today's EHRs helping to increase healthcare value.
Current EHR Capabilities
Current EHR Deficiencies
- Difficult to use and not interoperable. “The recent analysis was sharply critical of the commercial systems now in place, many of which are hard to use and do not allow doctors and patients to share medical information across systems” [reference]. “Providers continue to use workarounds to deal with perceived inadequacies of their electronic health records…such as difficulty in finding data and complex order entry processes” [reference].
- Fail to coordinate care and accommodate workflows. “Knowing all the different participants in the patient’s care team…and coordinating and integrating their electronic activities is what successful EHRs must handle with ease…Most existing EHRs…have…done a poor job [and] must...accommodate more fluid workflows that can change potentially daily or weekly based on the demands of new participants” [reference].
- Cause information overload. “EHRs often contain unnecessary or excessive information that "clutters the 'big picture' of patient care" and increases risk to patients…often you can't see the forest for the trees” [reference].
- Immature clinical decision support. “[T]he first generation of CDS [Clinical Decision Support] tools…in…EHR systems, has not lived up to expectations…[They cause] alert fatigue and [fail to] optimize [clinical]workflows” [reference]. “[F]uture generations of CDS tools will…be more tailored to both patients and physicians” [reference]. “[Additional R&D] is recommended…to bridge the gap between the promise and realization of [guided personalized medicine]” [reference].
- Does poor job with patient education and shared decision-making. “…health education materials delivered by EHRs are ‘rarely…understandable and actionable for patients’ who have low health literacy” [reference]. “Implementing shared decision-making isn't as easy as it sounds…the IT systems used…lacked capabilities to flag patients as candidates for decision aids or to track patients through the process” [reference].