Electronic health records (EHRs) have been part of the American health care landscape since the 1970s, when large academic hospitals experimented with in-house digital records. Progress was slow and inconsistent until the late ’80s and ’90s, when Health Level Seven International (HL7) entered the scene and electronic standards developed. Since that time, only the most progressive institutions pursued electronic patient records.
President Obama made EHRs a centerpiece of the 2010 Affordable Care Act (ACA), promoting their adoption with more than $30 billion in incentive payments between 2011 and 2015. Hospitals and office-based physicians have rushed to carry out the newly compliant EHRs, often with less than ideal outcomes. However, hospitals have put today’s high-tech EHRs to work for them in innovative and highly successful ways.
Cleveland Clinic Combines Business Intelligence and EHR Insight
The Cleveland Clinic was an early adopter of EHR technology, but the institution felt it was missing opportunities to improve patient care. Management made excellent use of the robust executive dashboard component of their Epic Systems EHR. However, data obtained at the point of care wasn’t being collected, analyzed, and acted upon to improve patient experience and overall satisfaction.
Clinic officials assembled a team of business intelligence analysts, health informaticists, and nursing executives to develop a short-cycle dashboard to give clinicians actionable information to improve patient care before discharge. The clinic’s goal was improving patient satisfaction and meeting federally mandated core performance measurements. Cleveland Clinic won an award from the The Association of Medical Directors of Information Systems (AMDIS) for this dashboard innovation.
Mayo Clinic Partners with Apple, EHR Vendor for Mobile HealthKit
Mayo Clinic was a leading adopter of EHR technology, implementing a well-designed patient portal to drive patient engagement and improve health outcomes. However, the clinic wanted a way to engage with the larger community, including consumers with whom Mayo Clinic did not already have patient-clinic relationships. Apple — already a market leader in mobile apps — was a logical partner, along with Epic Systems, the market leader in EHRs.
The collaboration led to the development and release of HealthKit, a repository for health information collected on wearables, such as Fitbits and other health tracking apps. These devices provide patients with a health dashboard that also interact with the clinic’s EHR system. An abnormal reading, such as elevated blood pressure, would trigger a series of information and recommendations presented within the HealthKit app. Mayo Clinic officials hope that in instances where recommendations include seeking a medical consultation or emergency care, the user will choose Mayo Clinic.
The clinic is also experimenting with using HealthKit to collect and monitor data on cardiac patients to attempt to reduce 30-day readmissions after inpatient cardiac episodes.
Advantages such as improved coordination of care, clinical decision support, and decreased medication errors are integral to most EHRs and are a major driver of implementation across the health care continuum. Both the Cleveland Clinic and Mayo Clinic have pushed the boundaries of EHR technology to find new and highly innovative ways to improve health outcomes and engagement with their patients and local communities.
Image via Flickr by Mulad