Future direction of EHRs laid down by AMIA

By John DeGaspari

Specific recommendations were recently outlined by the American Medical Informatics Association (AMIA) on what it sees as the present status and future direction of electronic health records. The findings were presented at the iHealth Clinical Informatics Conference in Boston on May 29.

The report focused on five key areas that should be addressed within the next five years: simplify and speed documentation; refocus regulation; increase transparency and streamline regulation; foster innovation; and patient-centered healthcare.

Specific recommendations in the report include:

  • Decrease the data entry burden for clinicians by encompassing information entered by other care team members
  • Separate data entry by the patient, family members and the care team, which can be used to generate customized reports
  • Regulations should clarify and simplify certification procedures; improve data exchange and interoperability; reduce the need for re-entering data; and prioritize patient outcomes
  • Flexibility and transparency in how a vendor should satisfy certification criteria, to improve usability and safety and fostering innovation
  • Integration of EHRs into the full context of care, including home health, specialist care, laboratory and long-term care

AMIA CEO Doug Fridsma (pictured) and Tom Payne, M.D., chair of the EHR-2020 Taskforce, said in an interview with FierceEMR that the report's goals were achievable in a short time frame.

Fridsma said some of the report's recommendations reflect progress already being made, while others call for simple changes that can potentially create value. He noted that improving documentation would empower patients so they can be "first order participants" in their healthcare.

Fridsma said the targets the Centers for Medicare & Medicaid Services have put forward in terms of alternative payments ultimately would allow for more flexibility and for the ability for all members of the caregiver team to incorporate information into the care of the patient.

Payne noted that many of the report's recommendations were already underway. For example, the OpenNotes initiative to give patients access to their doctors' notes--pioneered by Beth Israel Deaconess Medical Center, Geisinger Health System and Harborview Medical Center--is rapidly being adopted by other health systems. He predicted that the ability of patients to engage in their healthcare through health portals and mobile devices will become widespread.

"I am optimistic that we can make enormous progress," Payne said. Speaking of the transition to EHRs, he added: "We understand how hard it has been; but we can do better, and this is the first of many efforts to start down the path to make EHRs achieve more of their promise."

AMIA has previously listed ways that usability and safety of EHRs could be improved. In 2013, the association published a position paper in its journal outlining 10 ways to reduce errors, increase patient safety and improve efficiency.

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