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EHRs in the New Health Economy: Essential but insufficient

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Electronic health records (EHRs) were once billed as the lynchpin to moving the US health system into the digital age. But the largely swift adoption of these systems may have slowed the industry’s transition to the New Health Economy.

Today, EHRs are largely used for billing and payment, not as building blocks in a larger health IT ecosystem helping to advance care delivery, deliver population health or meet consumer expectations. However, there are lessons to be learned from organizations that made the move to EHRs as part of a broader business strategy. In many respects, these “strategic EHR implementers” are further along.

In order to realize a return on their investment, providers will need to start viewing their EHR as a strategic asset and look to other technologies to address EHRs’ limitations.

Providers will look to other technologies to address EHRs’ limitations.

While providers have many chances to maximize uses of their EHRs and the data within them, they also must understand the systems’ limitations and use additional technologies to help fill the gaps.

Overall, consumers are more positive than clinicians about the impact EHRs have had on care delivery and the patient experience.

How are providers using EHRs today

Care standardization and decision support

  • Clinicians face data entry exhaustion due to lack of standardization and an inability to automate data capture that works poorly with clinician workflows.
  • Due to the lack of rigor around EHR data entry, clinicians haven't been able to use data to reduce variation in the way care is delivered and therefore achieve better, more predictable outcomes.
  • Strategic implementers appear to be further along on digitizing and standardizing clinical documentation. Eighty-four percent told HRI they are using the EHR for clinical documentation, compared with 63 percent of other providers.

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Population health

  • EHRs have been effective for aggregating clinical data to support descriptive analyses of patient populations.
  • More mature data models - not available in EHRs - are needed to integrate other data sources in order to stratify patient populations based on risk and then manage them.
  • A key component of population health analytics is the ability to tie EHRs from different systems together in order to exchange information.
  • Population health also requires that providers understand patients’ lifestyles and the social factors affecting their health – information the EHR is generally not poised to capture.

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Patient engagement

  • Most consumers think EHRs have made it easier for their doctors to communicate with them, but providers think the systems have interfered with face-to-face care.
  • Many clinicians have not embraced the significant potential of their EHR’s patient portal, using it largely to help patients schedule appointments or manage bills rather than manage their health.
  • Strategic EHR implementers are more likely to already be using their EHRs to enhance patient-provider communication, but they also recognize that the EHR alone may not be enough to meet patient expectations and encourage them to become more engaged in their care. More strategic implementers than other providers are using customer relationship management software to ensure that services such as diabetes management programs or smoking cessation groups reach the patients who would benefit from them the most.

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  • Other than academic medical centers, many providers have not prioritized EHRs to support practice-based research efforts.
  • EHRs often provide analytic tools that are effective for descriptive, retrospective reviews of patient populations.
  • EHRs tend to lack the capacity to do more robust analyses, such as predictive modeling which can help providers uncover a patient population’s future needs.
  • Providers, including strategic EHR implementers, plan to focus on non-EHR technologies for research and clinical trials recruitment over the next three to five years.

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What this means for business

View the EHR as a strategic asset versus merely the cost of doing business. Strategic EHR implementers are ahead of other providers in many respects because they took time to assess what they needed from their EHR to deliver on their current strategic plans and to help create new strategies.

Tighten up data governance. Many organizations either don’t have anyone responsible for enterprise analytics, or they assign it to a clinical leader who isn’t familiar with the organization’s breadth of data sources. Many other industries now have chief data analytics officers who oversee all of an organization’s data.

Don't be too quick to build it yourself. Consider buying or acquiring data and data models through partnerships. Some providers have hired data scientists to build home-grown analytics and data models, but they recognize they can’t compete with the big EHR vendors.

Use proprietary data as a new revenue source. Providers might consider packaging and selling the insights they generate from EHR data. Just as retailers suggest products and services to shoppers based on their buying patterns, providers should invest in predictive models that can suggest products and services to help consumers manage their health, creating another potential revenue source. 

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Chris Van Pelt

Chris Van Pelt

Principal, US Health Industries, PwC US

Sarah Haflett

Sarah Haflett

Director and Research Leader, PwC Health Research Institute, PwC US

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