- Widespread EHR adoption has so far produced only modest improvements in clinical productivity and efficiency, but two doctors anticipate increased competition, diversity, and growth in the health IT and EHR market will yield the advancements clinicians expect.
In a recent JAMA op-ed, University of California San Francisco (UCSF) Department of Medicine Professor and Chair Robert M. Wachter, MD, and Google Research Chief Clinical Strategist Michael D. Howell, MD, listed several reasons why clinicians should remain optimistic about the potential for health IT and digitization to improve care delivery despite rising rates of physician burnout.
Physicians, nurses, and other clinical staff have voiced concern and disappointment about the false promises of EHR adoption. While the technology has yielded some improvements in quality and safety, the demands of clinical documentation and EHR use detract from patient care.
Wachter and Howell predict healthcare is on the verge of overcoming the initial struggles and stagnation that accompany widespread change.
“The lesson from other industries is that the productivity paradox eventually resolves, often over 1 to 2 decades,” wrote Wachter and Howell. “This was true both for the electrification of factories at the start of the 20th century and the digitization of manufacturing, banking, and retail at the turn of this century.”
“Researchers have identified 2 keys for this resolution: improvements in the technology and a reimagining of the work,” the duo continued. “Health care is now poised for similar improvements.”
The expanding health IT and EHR marketplace will help to bring about improvements in care delivery by incentivizing diverse businesses — from start-ups to tech giants such as Google and Apple — to leverage the wealth of health data currently available for smarter, more accurate technology.
“Drawn by the business and clinical opportunities potentially associated with leveraging these data, investments in health care start-ups have increased substantially, and virtually all major general purpose technology companies have announced significant health care initiatives,” stated the physicians.
EHR vendors including Cerner and Epic have been driven by market pressures to build advanced data analytics capabilities into EHR technology in the form of population health platforms and other health IT modules.
The continued success of smaller, specialized health IT companies such as Mobile Heartbeat and Nuance that design EHR-integrated health IT solutions will also help to diversify the market and provide healthcare organizations with unique tools.
Wachter and Howell acknowledged that EHR interoperability and information blocking remain industry-wide impediments to progress.
“For various reasons, some of these vendors have tried to limit the ability of other parties to extract data from their systems, but it seems likely that the next phase of health care digitization will overcome such barriers,” the two wrote.
Pairing liberated EHR data with new innovations will allow for an explosion of clinical advancement. Machine learning and artificial intelligence (AI) will also be key to these improvements.
“In health care, these techniques now allow computers to identify diabetic retinopathy with accuracy similar to that of experienced ophthalmologists,” wrote the physicians. “Once EHR data are fully unlocked, rapid improvements may occur in the ability to make knowledge and insights that were previously possessed only by specialists available for the care of every patient.”
While the digitization of healthcare has so far been an expensive headache for many healthcare organizations, progress will soon come with the help of evolved systems thinking, population health initiatives, AI, and increased business investments in health IT.
“Although this transition is sure to be challenging and somewhat unpredictable, history suggests that the most likely result will be higher quality, safer, more satisfying, and less expensive health care, and better health outcomes,” the pair concluded.