ViVE Panel Offers a Progress Report on EHRs

Executives from three companies took to the stage this week in Los Angeles and said they're working hard to make their platforms more intuitive and convenient for both providers and consumers

AI and VR may be the cool new tech that everyone's talking about, but don't forget the EHR.

Executives from three of the nation's top EHR companies shared a stage at ViVE this week to tell an overflow audience that the medical record platform is chugging right along. And they emphasized that innovation is very much a part of their future.

"Our job is not done yet," Helen Waters, executive vice president and chief operating officer at MEDITECH, pointed out.

EHRs have had a rocky history in healthcare, with one popular opinion that they were forced on doctors and nurses before the industry was really ready to embrace them. But the benefits have grown right alongside the challenges, and like any other technology it's taken time to smooth out the rough edges. The latest surveys indicate only 4% to 6% of the nation's hospitals haven't adopted EHRs.

And as healthcare shifts to value-based care models and embraces new tools to improve clinical outcomes and provider workloads, a lot of that progress will pass through the foundation laid out by the EHR. Waters noted that some of the biggest disruptors in the space are working with both EHR companies and health systems to develop AI programs.

Mike Sicilia, Oracle's executive vice president, said his company and others in the space have to keep up with the concept of value-based care, embracing avenues that enable the consumer to take more control of his or her data and give providers the tools they need to address health and wellness and social determinants of health.

"Systems of record are very good at telling you what happened," he noted, "but not as good at telling you what may happen."

Part of that is developing tools to sift through the incredible amounts of data coming in, finding value to providers and giving them what they need. Doctors and nurses don't necessarily want to see more data, but they do want to see the right information.

Trevor Berceau, Epic's director of research and development, said EHR integration is a key element to the success of any new technology in healthcare, and companies should be working to make sure the platform is as easy and intuitive for physicians as the healthcare experience should be for consumers. With provider stress and burnout one of the biggest pain points in healthcare, much of the innovation now taking place is focused on improving workflows and helping doctors and nurses to use the EHR more efficiently.

But Berceau said EHR companies sometimes shoulder too much of the blame. For example, he said, federal guidelines around documentation are complex and cumbersome, and medical notes in the U.S. tend to be four times longer than notes taken by providers in other countries. There needs to be a balance between how much is required of providers using the EHR and how that affects their workflows.

The conversation naturally turned to interoperability, a key buzzword and the focus of a federal effort to create a nationwide framework for data exchange. All agreed that TEFCA and FHIR are good concepts, and that the interoperability train will continue to chug along, running through crowded stations where a wide variety of passengers—health systems, vendors, HIE networks, and other providers—try to get on.

"I wouldn't say it's great; I wouldn't even say it's good enough," said Sicilia, adding that "data interoperability for providers and patients is a basic right."

"We've come a long way [and] there's still a long ways to go," added Berceau. "I don't think that we'll ever be done with interoperability."

That said, there is a consensus that hard lessons have been learned from the legacy era of EHRs, and today's platforms are more malleable. Waters said the industry is moving forward with the goal of "making information easier to find … and more intelligent." And innovation is just as much a goal of the vendors in the space as it is of the providers looking to get more out of their technology.