The Future of EHR's (Part 1)

Over the last two years, we have dedicated this blog to national and international general healthcare issues. We have attempted to highlight how fundamental changes in payer models, demographics, and how health information technology is converging to cause both problems and corresponding opportunities.

Over the last six years, we have witnessed hundreds of billions of U.S. dollars invested in new, and in most cases, short-lived, unfunctional and time-consuming electronic healthcare records. We have witnessed hundreds of fortune seekers enter the industry, with the passage of the U.S. government mandates, thinking that application and technology experience in other industries would be easily transferred to healthcare. Most of those fortune seekers are gone. Yet, providers face more challenges and changes today than they did six years ago due to the increasing mandates, and the remains of the attempts to piecemeal solutions to healthcare from other industries. The U.S government is now accelerating implementation of new payer modules and reporting requirement (MACRA) that will have material and lasting financial impact.

What ROI have these investments gained for us as a nation?

The facts tell us that very little has been produced.

Yes, the nascent health information technology industry exploded, however it exploded with capital and leaders with little to no actual healthcare experience. Providers were flooded with new and complex technology and little support that lowered overall productivity. In the end, it left the healthcare industry with more complexity, not more efficiency, making it even harder to prove, let alone provide, a better quality of care.

A recent industry survey of thousands of physicians noted that many providers were spending up to 40% of their work time dealing with accessing and inputting data into EHRs. Nearly no one could say that the quality of care was improved. However, they were complying with U.S. government mandates, requiring approved Meaningful Use-2 (MU-2) EHRs, to avoid government directed penalties.

The reality is, nearly all EHRs today bring minimal value to providers. Most are usually very complex and have an “evolved” medical billing platform that use the EHR as a front-end to gather the relevant information to support the billing company in submitting a claim, rather than supporting the physician in providing better quality of care in less time. The billing company’s incentive is to gather as much data directly from the provider to document a medical claim, and receive a payment for which the billing company is paid a percentage of the doctor’s receipts.

Another type of EHR is incredibly robust in certain specialty practice areas: oncology, orthopedics, dermatology, neurology, etc. Unfortunately, these miss the real need for care to be integrated across the patient’s Care Team.

What we as an industry have done, is to make data move faster at a greater cost with little sharing of information among the providers who are providing the care to a single patient. We have also missed the opportunity to connect directly with the patient.

From our experience, the average patient over age 65 has four active providers, and four to six active medications. For the most part, the patient is their own Care Coordinator, and if given access to their medical records from those providers, they must login generally to four or more different EHR systems with four different logins and communication platforms.

We saw a different path and have spent years building for the future. In an evolving world that is demanding better and more consistent outcomes, PWeR® (Personal Wellness electronicRecord®) was designed to take advantage of technology to both provide better and more cost-effective care. This model rewards the doctor with more time and better outcomes, and the patient is completely informed.

Only when systems are designed to be collaborative and focus on wellness versus simply using technology as a compliance tool or faster medical billing for the treatment provider, will we optimize the true power of technology in healthcare interconnecting providers and patients toward a wellness-driven, patient-centric healthcare delivery system.

– Noel J. Guillama, President