Three Must-Have Features in Modern Custom EHR Systems

By Liza Dzhezhora

Although the healthcare industry has used EHRs for a long time, these systems are constantly being redesigned to meet the challenges of the times as well as become more helpful for providers. In this article, we will explore the changes that custom EHR systems have seen recently, and how they help overcome the challenges brought about by the pandemic and other significant healthcare events.

The addition of SDOH

During the pandemic, social determinants of health (SDOH) caught doctors’ attention. Before this crisis, healthcare marketing departments collected SDOH data and used it for drafting campaigns, but the industry doubted the data’s value for understanding health outcomes or patient decision-making.

Today, things have changed. The pandemic affected vulnerable populations the most, so taking into account SDOH that may affect patients’ health outcomes has become critical. However, adding SDOH to an EHR can prove difficult due to the lack of interoperability among health systems.

Here are some useful tips to employ when aggregating SDOH into your EHR:

1. Defining the focus. Certain factors play critical roles in a person’s health-related decisions, health status, and access to care: education, employment, and income. Social support is yet another important determinant—unfortunately, there is no one-size-fits-all solution for solving social challenges. According to Bridging Gaps to Build Healthy Communities, a report by Anthem Public Policy Institute, different chronic conditions call for prioritizing different social challenges. The researchers studied patient forums and detected several trends. For example, cancer patients’ key priority is access to healthcare. For patients with diabetes, food security is a larger concern. To use SDOH efficiently, experts recommend starting with social challenges that resonate with large patient populations. According to the Centers for Disease Control and Prevention, cancer, diabetes, and heart disease are the top three chronic conditions in the United States. So it is reasonable to begin by addressing social challenges in one of those patient groups.
2. Collecting the data. There are three primary data sources:

• Marketing data. If your marketing department has suitable and freshly gathered data at hand, you can safely use it for solving social challenges.
• Public records. Population census data and other reports from trusted agencies are credible and regularly updated and therefore can serve as SDOH data sources.
• Virtual patient questionnaires. To enable this SDOH gathering method, you need the help of your IT vendor or in-house team. They can build an SDOH-collecting tool into the EHR system so patients can fill in the information when accessing their health data. Make sure the add-on is unobtrusive and allows patients to choose whether to share the information.

3. Adding the data. You can aggregate SDOH data into an EHR manually or virtually. To input the data manually, you’ll need to involve your administrative workers, but this method is time-consuming and error-prone and isn’t viable for large practices or healthcare networks. To add the data virtually, you’ll need the help of your internal IT department or an external provider. Because a regular EHR system may not have enough storage to host SDOH data, your organization’s IT specialists may have to connect with the EHR vendor to have storage added or allocated for this data.

Upscaled data sharing

During the pandemic, the importance of sharing clinical data grew tremendously. This is why many healthcare providers, especially neighboring clinics, started doing so. There are several ways to ensure cross-provider interoperability with the help of an EHR:

1. The Fast Healthcare Interoperability Resources (FHIR) standard works like a transport layer, enabling disparate medical systems to exchange data. Though the standard’s benefits are undoubted, it doesn’t guarantee interoperability by default. To let providers make their EHR systems interoperable without complex rework, the standard offers several implementation models consisting of over 50 interconnected items (resources) employed individually or in combination. The models cover basic data sharing use cases, but limiting yourself to a set of resources relevant to your clinic may hamper interoperability. Fortunately, another option is available: health information exchanges (HIE).
2. An HIE is a programmatic solution enabling providers, patients, and other industry players to share medical data safely and securely. HIEs can work on a state, region, or national level. They also have the potential to become unified care coordination and provision points. For example, the Nebraska HIE added SDOH data and teamed up with a social services network to establish Unite Nebraska, which lets state residents access housing options, nutrition services, and more via community organizations. The lack of EHR interoperability affects data exchange between providers. A large provider, especially a general hospital, may also use disparate health systems within its walls that don’t interact well. In such a case, the organization should consider replacing those tools with a unified electronic records solution.
3. Unified EHR. This option allows a large provider to use a common EHR across its locations by creating a systemwide interoperable environment. Following this strategy, Baptist Health South Florida, a network of 12 hospitals and 100 outpatient centers, deployed a cloud EHR to unify the patient records they host. The effort was aimed at improving provider engagement and care provision for cancer, orthopedic, and cardiovascular patients.

Providers can also establish data-sharing partnerships with neighboring clinics to ensure EHR interoperability and improve care for patients referred from those clinics. Given the diversity of options for ensuring cross-provider interoperability, it makes sense to explore the available solutions to discover which one suits you best.

Support of patient-generated health data (PGHD)

The use of remote patient monitoring (RPM) solutions and diverse health-related consumer devices has grown significantly during the pandemic and continues to rise, according to Insider Intelligence. Hence, organizations have a growing need to integrate that data into the clinical setting. Electronic records have become an optimal solution to host PGHD. By 2025, the number of users who self-monitor their health and share the resulting data with their doctors through EHR systems will reach 70.6 million people.

EHR support for PGHD contributes not only to patient care personalization but also to shared decision-making. This process paves the way to better patient-provider partnerships that can foster better health outcomes and quality of life without extensive costs.

Summing up

The pandemic caused a full-scale technological advancement in the healthcare industry. Providers and health IT vendors are trying to adapt to the new norm, which calls for reconsidering key concepts and tools. Thus, long-ignored SDOH are steadily making their way into EHR systems. In addition, the possibilities of data sharing between patients and providers are expanding. Modern custom EHRs integrate PGHD to foster collaborative decision-making regarding one’s health.

Recognizing the changes in healthcare as a whole, vendors are trying to adapt EHR systems to accommodate industry challenges and the evolving requests from healthcare providers. Judging by these timely adaptations, we can confidently say that today’s EHRs are designed to help doctors solve everyday problems, taking into account the current situation in a particular region or country.

Liza Dzhezhora is a healthcare IT analyst for Itransition.