via a Shared EHR platform, PCEHR or other. As such, the use of mobile devices including smartphones and tablets must be supported and encouraged as long as the appropriate measures are taken to secure the data. In fact, one health system we’ve worked with in the US is currently leveraging its Shared EHR platform to deliver data to clinicians on BlackBerry smartphone devices. Clinicians are afforded a single, comprehensive view of patient data — allergies, medications, lab results and physician notes for example — critical to the medical decision-making process.
The Workflow Conundrum The second area of challenge and growth for Shared EHRs comes in the form of the need for data to be integrated within all stakeholders’ familiar workflows. Notably, these solutions must ensure clinicians and other users need not exit day-to-day workflows and applications. Providers seek finger-tip access to comprehensive information, and baulk at adopting technologies that require they open and close multiple programs to get the information they need. Some solution vendors are partnering with
third-party EMR providers to develop strategies by which data is integrated into clinical workflow to ensure clinicians have the right information delivered to them to properly handle the immediate episode of care. Furthermore, these caregivers must have the ability to drill into greater detail on the patient when necessary by accessing information from a variety of clinical or other systems as the situation demands. Without semantic interoperability, clinicians would
likely find themselves wasting time searching for data in disparate information systems that incorporate various workflows and presentation formats. And once they have the information in hand, they must still interpret data that was likely compiled over a period of time and by many different individuals, resulting in values that aren’t aligned. EMRs of the future will thus likely incorporate EHR-aggregated data directly into users’ preferred workflows without them being aware of ‘vendor dependencies’. Having said that, the road to getting the various
EMR vendors to play ball is largely bumpy and unpaved. As a result, Shared EHR vendors like ourselves need and have begun to develop tools to get the EHR data into the
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clinician’s workflow without requiring EMR vendors to actively enable the integration.
Secure, Secondary Data Use Perhaps the greatest area of variability across Shared EHR deployments is how they ultimately ensure that medical data is highly secure, yet available and useable by authorised individuals. Technology exists today to lock individual health information tightly away in databases. A strategic combination of secure yet accessible technologies and strong policy guiding who has access to the information must be in place before any Shared EHR solution is deployed. This commitment enables greater control over whom has access to which data sets and under what circumstances. When this is achieved, opportunities to provide
information to patients in a secure and appropriate environment — the tenets of the PCEHR — promise to create a consumer-friendly atmosphere in which patients have greater control over decisions related to their care. The Shared EHR platform should also facilitate
the extraction and use of de-identified information to be used to advance the health of populations and the community as a whole — including for research into care plans and treatments that exhibit greatest value — and analytics to measure efficacy and outcomes. When rolled up to an organisational level or beyond, healthcare leaders will be able to view medical trends, and apply the knowledge to managing diseases and overall population health.
Conclusion With Shared EHRs, healthcare consumers and providers will have access to relevant and timely data where and when it’s needed to drive informed medical decisions. As these solutions are deployed they typically gain considerable uptake, and in turn create broader demand for increased reach (both data sources and outputs) and increased integration into clinicians’ workflows. Future stakeholders realise that by creating secure yet ubiquitously integrated information, they have the potential to make use of this information for applications that could only be dreamt of in the past. That’s where real challenges will lie in term of medico-legal and ethical considerations. But we have a few years to prepare for that debate. It’ll be interesting, I can tell you that much.
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