How Electronic Health Records Can Improve Patient Care

The systems, often a divisive topic for patients and clinicians, show new capabilities, connectivity and ease of use.

Electronic health records do more than collect and store patient information. Increasingly, these records compute and communicate the data, providing insights that can make a difference in treatment.

HealthIT.gov reports that 75 percent of healthcare providers say their EHR enables them to deliver better patient care, which results in higher patient satisfaction rates and fewer medication errors, among other benefits.

These systems, though associated with higher physician stress and burnout, can be lifesaving when managed efficiently. Data shared in an EHR can help clinicians choose the right medication for a patient with allergies, for example, or provide history on an unresponsive patient when they arrive at an emergency room.

An EHR can also play a role in public health outcomes by allowing clinicians to look more meaningfully at patient data when it comes to their current medications and specific conditions such as high blood pressure or low blood sugar.

The path to high functionality is a slow process. But most improvements in today’s EHRs can be attributed to the ever-growing prevalence of technology in patient’s lives and a demand for medical tools to be more intuitive and user friendly, says Dr. Bruce Darrow, chief medical information officer for Mount Sinai Health System in New York.

“Fifteen years ago, when I started practice, nobody complained that I couldn’t see their record because nobody expected me to be able to,” says Darrow. “But year after year, the ability to get information is both easier and broader than it was previously. When it works, it is a beautiful thing.”

MORE FROM HEALTHTECH: A look at the problems and potential of EHRs.

Mount Sinai Continues Development of Robust EHR System

Mount Sinai has no shortage of exposure when it comes to EHR systems. In its work with Epic (its EHR vendor) over the course of roughly 20 years, the system has grown from a single EHR for ambulatory care to a full implementation across all departments in five hospitals.

Kristin Myers, the senior vice president for IT governance at Mount Sinai, tells HealthTech that visits to the organization’s records system in the ambulatory care space alone have reached roughly 4 million to date.

Patti Cuartas, Senior Director of IT, Population Health and Payer Systems, Mount Sinai Health System
We’re pushing our EHR to the limits, making sure that we're able to coordinate care, which is our goal for patient care and better outcomes and increased quality."

Patti Cuartas Senior Director of IT, Population Health and Payer Systems, Mount Sinai Health System

With plans to expand the EHR to a sixth hospital in May and a seventh by 2022, Mount Sinai is working closely with its vendor to ensure the system is evolving as necessary. The health system’s continued goal is to better meet the expectations of patients, providers and clinicians, especially those who are relying more heavily on mobile technology.

“We always look to see if Epic is able to do the new requests and the new functionality that we need. And if it can't, we give the vendor enough time to develop it, and they usually do,” says Patti Cuartas, senior director of IT, population health and payer systems at Mount Sinai. “We’re pushing our EHR to the limits, making sure that we're able to coordinate care, which is our goal for patient care and better outcomes and increased quality.”

Patient Satisfaction Is Improved Upon Through Mount Sinai’s EHR

Mount Sinai has seen measurable successes from its EHR implementations and ongoing adaptations. Among them: an increase in timely patient discharges, a decreased number of days spent in the hospital and a higher telemetry capacity.

Darrow recalls a particularly memorable example. A patient with records from two other hospitals had come to him for a third opinion. Mount Sinai’s robust electronic records system allowed the clinician to collect and analyze the data in advance, allowing the patient to be treated without having to retell his whole treatment story.

At the end of the visit, Darrow offered words of comfort to the patient and his wife: “Here's what I think, this is how my opinion either is concurrent or discordant from what the others said at the other hospitals, and I'm going to write it out for you,” he said, noting that the couple was told they’d have full access to those details via a patient portal and the notes could be shared with anyone on their care team going forward. 

There were tears in their eyes,” Darrow said.

75%

Percentage of healthcare providers that say their EHR enables them to deliver better patient care

Source: HealthIT.gov, "Improved Diagnostics & Patient Outcomes," June 2019

Such an exchange would be impossible without a network that can handle the added bandwidth, Myers notes. Although there are upfront costs associated with the EHR system itself, a substantial portion of any rollout budget should be dedicated to the network and to making sure infrastructure can support a system efficiently and effectively.

“Every time we start an implementation, the first thing we look at is all of the infrastructure components — whether it's wireless, the physical network, do we have enough network drops to be able to support business continuity, disaster recovery, do we have enough PCs or iPads to support the workflow,” says Myers. 

DISCOVER: How to get the most out of your EHR implementation.

Northwell Health Looks to the Future with Its EHR

Northwell Health, New York State’s largest health system, is also focused on enhancing its EHR to improve patient care and satisfaction. 

One particular area of interest for the organization is using the patient portal as an extension of patient health records. John Bosco, Northwell’s CIO, sees the health system’s portal as a means to collect, store and share health information, noting that patients “like the convenience of being able to see their records, renew a prescription and send a secure message to a physician.”

When it comes to Northwell’s current patient portal plans, Bosco says the organization not only wants to make it more approachable and accessible via patients’ mobile devices but also more impactful by providing patients tailored treatment information based on the medical history found within their electronic record.

In conjunction with the EHR provider Allscripts, Northwell is also focused on enhancing the capabilities of its EHR system as a whole, creating a next-generation records system that is rooted in cloud, voice recognition and artificial intelligence technologies designed to handle some of the administrative tasks that often lead to employee burnout.

“We think there's really significant opportunity as you look years down the road of a physician just being able to speak out loud and have that picked up and transcribed accurately into a medical record,” says Bosco. “We've got a whole list of advanced capabilities that we believe a next-generation records system should have, and that's certainly one of the bigger ones.”

Those capabilities include collecting real-time data from wearables and Internet of Things devices within the records system and using AI and machine learning to help clinicians interpret that data. 

For now, Bosco believes that electronic records systems are already making a significant positive impact, despite “a cost that is not insignificant.” 

Still, he says, “it's definitely helped with sharing information. And the more a physician understands about your medications, your problems, your allergies, your history, your health history, the better off they are in being able to treat you.”

Eva-Katalin/Getty Images
Nov 27 2019

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