Electronic Health Records 2.0: What Does the Future Hold?

Vice President with experience in Health IT and HIEs

Electronic health records (EHRs) began to emerge in the health care world about 30 years ago. During those three decades, technology in general has made huge leaps forward – the difference between the computers of that time and today is enormous – and EHRs’ platforms have evolved as well, moving from stand-alone terminals to enterprise applications supporting mobile devices and tablets. However, their basic functionality has evolved little since those early days, and as a result, they are falling short of realizing their full potential.

But that may soon change. The federal government’s Meaningful Use Incentive Program has begun to increase EHR adoption significantly, which may alter the landscape of health care as we know it. The California HealthCare Foundation (CHCF) recently published an issue brief titled “What's Ahead for EHRs: Expert Weigh In” (available at http://www.chcf.org/publications/2012/02/whats-ahead-ehrs) in which industry experts across the health care and informatics community offered their insight on the role of meaningful use in shaping the current and future EHR landscape. Many of the experts believe EHRs have the potential to enable vast improvements in health care quality by increasing workflow efficiencies and patient safety; offering appropriate medical providers complete, accurate, and timely information; and empowering patients to be more active participants in their own health.

Meaningful use has created a “tipping point” for EHRs, and the increased adoption is likely to help increase patient comfort with EHRs and health IT in general. Over time, patients will likely demand the convenience of scheduling appointments and refilling prescriptions online, and may begin to avoid practices that are not readily accessible "on-line." Meanwhile, providers and hospitals that do not share data or allow patients to readily access their information may face a loss of market share or risk decreased payments. Likewise, as employers and insurers recognize the cost-saving and quality-improvement potential of health IT, they will be likely to require providers within their networks to implement EHRs as a standard practice of good medicine.

Increased EHR use also has implications for population health, and we are already seeing communities coming together to improve health reporting through EHRs. In the future, this data could be used as a social metric, helping to rank our communities by measuring their overall health, including level of smoking and diabetes, and the amount community members tend to exercise. The information could also help look at how social services are being used in the community, ensure that those services are going to those who need it most, and track improvements over time.

We’re seeing some of this happening now, but health information exchange is still fairly weak. Most EHR systems still exist in silos, and sharing information between those silos can be challenging and costly. It is unclear whether the health care community will be able to maximize the potential of EHRs and health IT. The future is bright, but it will take considerably more effort from the community as a whole to get us there.