In an environment where financial margins are increasingly strained, hospitals and health systems can no longer ignore the $800 billion problem caused by inefficient administrative workflows. Almost all of today’s healthcare workflows have been built around electronic health records (EHRs), which serve as phenomenal systems of record but have struggled to evolve into effective systems of engagement.
Because of this, many providers and staff spend more time inside the EHR than on direct patient care. Even more challenging is that due to lagging support for interoperability, providers have struggled to surface EHR data into applications that make provider and patient workflows more efficient.
Healthcare leaders looking to address these administrative inefficiencies have three paths to choose from: Buy new technology to replace existing EHR functionality, rely on policymakers in D.C. to implement legislation that accelerates EHR interoperability or extend existing capabilities of the EHR to meet modern patient and provider requirements.
I’d argue that within our current landscape, the third path is our only viable option.
We have been down the first path before. The rip and replace approach further exacerbates data silos, increases operating costs and, perhaps worst of all, can result in the loss of patient-generated health data.
The second path is less promising. Even with widespread support, implementing legislation in attempts to address systemic issues, such as interoperability barriers, often take years to be realized in clinical practice. For example, the ONC Cures Act Final Rule, which implements requirements outlined in the 21st Century Cures Act, will take three years until it is fully rolled out. As innovation in the digital health space continues to outpace legislative developments, our workforce, industry and economy cannot afford to wait for Washington.
The third, and most realistic path, involves taking a cue from other industries: implementing technology to modernize the EHR, unlocking access to data for use by applications that provide modern patient experiences and automating manual administrative workflows.
Capabilities like robotic process automation (RPA), for example, provide access to any capability or data that a human would have access to inside the EHR and make it accessible to software. RPA enables health systems to extend the capabilities of the FHIR application programming interfaces that many EHR vendors have provided while accelerating adoption by providing an additional path to work with data in the EHR.
In healthcare, RPA streamlines administrative workflows and improves the patient experience by surfacing previously inaccessible data to enable more personalized care.
Innovators across other highly compliant and regulated industries have used this approach to great effect. For example, when I led the product organization for a digital lending company to reinvent the mortgage experience, we worked with leading banks to modernize decades-old legacy mainframes and surface data through our mortgage processing platform, enabling them to dramatically accelerate the speed at which they could qualify and close applicants for loans. This required examination of the entire data stream in the mortgage process to determine why current methods exist and reconfigure them toward the ideal consumer experience, including how machine learning could be used to intelligently solve problems.
Extending legacy technology using modern tools helped bring the consumer lending process into the 21st century. By working within instead of around systems of record in healthcare, we can build on technology investments already made to do the same.
For example, providers looking to build a mobile check-in and visit experience can use intelligent automation to extract patient data in the EHR and use it to automatically fill out fields that the patient has shared in a previous visit. Likewise, everything patients share in their mobile intake and registration can be automatically populated back into the EHR, providing an up-to-date patient record for providers and freeing up staff capacity to spend time on patients, not data entry. This provides a modern user experience for both patients and providers that more closely mirrors what they have come to expect in other aspects of their lives.
As healthcare leaders evaluate their digital infrastructure and future investments in the COVID-19 era, extending the EHR through intelligent automation can power a variety of strategic initiatives, from attracting more patients to increasing staff and clinician capacity. By modernizing existing investments, providers can drive meaningful engagement and needed changes to patient experiences—as well as their bottom line—in a matter of months, not years.
Pranay Kapadia is the CEO at Notable Health.