Healthcare technology is advancing at a rapid pace. While healthcare innovators have always been willing to push boundaries to make discoveries that can drastically change outcomes (for the better) for patients, the same has not always been true when it comes to technologies that aim to improve the way healthcare organizations manage their data. Privacy and regulatory concerns have long placed a leash on technology innovations that would make data more accessible and shareable, so for years, companies have tried to walk that tightrope between maintaining adequate data security and making better use of their data.
The tide is starting to turn, however, as the healthcare industry is painfully aware of the need for more innovation that can transform many aspects of healthcare delivery. EHR and EMR integration are particular pain points. As government and industry alike push for EHR interoperability. HL7 standards made waves, but fell short, and FHIR soon took over as the interoperability buzzword du jour – but shares many of the same challenges of HL7 integration.
With a continued focus on health IT and its potential to enable better, faster, and more comprehensive healthcare delivery a reality, big changes are on the horizon. To find out where today’s healthcare and health IT leaders think EHRs are headed in the future, we reached out to a panel of healthcare professionals and health IT experts and asked them to answer this question:
“With advances in healthcare technology, what does the future hold for electronic health records?”
Meet Our Panel of Healthcare Pros & Health Technology Experts:
Read on to find out what our panel had to say about the future of EHRs.
Dr. Bryan Laskin
Bryan Laskin, DDS is the founder of Lake Minnetonka Dental in the Minneapolis, Minnesota area. Along with founding his dental practice, Dr. Laskin has started several technology companies to aid healthcare practices including a HIPAA compliant communication system called OperaDDS and a virtual reality system for dental patients called OperaVR.
“There are three big priorities for the future of electronic health records…”
Interoperability is crucial. Healthcare offices need to be able to communicate with each other and share patient information quickly, easily, and securely. Some offices and practices have already made the leap and invested in the type of software that makes this easy. Soon, those that still haven’t will no longer have a choice. Patients and employees will demand it.
Communication systems will continue to become more compatible and user-friendly. I created OperaDDS, a cloud-based communication system that allows a dentist to securely communicate with their team, their patients and other providers from any electronic device: computer, smartphone, tablet, and even smartwatch. Interoperability not only improves the patient experience, it also enhances the delivery of care for healthcare employees.
As one of patients’ top concerns is making sure their personal information is safe, we must continuously improve our security measures. Patients need to trust their medical and dental providers are taking every precaution to protect their information from being hacked or stolen. Creating and securing unique, individual logins for everyone using the system is a key part of any communication system handling personal health information or record sharing software.
Teledentistry and telemedicine are expanding quickly, and there is no looking back. In order to provide the best patient experience, healthcare systems and practices will need to offer this service. Obviously, this brings with it the responsibility of protecting information patients share on these systems. Teledentistry and telemedicine will also become more integrated with the old-fashioned record keeping process. When you send in photos or type out descriptions of your concerns in that telehealth system, it will become a part of your permanent medical record. Patients might describe a health concern one way initially and a different way during an office visit. The record of your initial telemedicine contact is valuable information for doctors and dentists to be able to reference when working to determine what’s wrong and what the best treatment option is.
Dr. Kyle Varner
Dr. Kyle Varner is a physician specialized in internal medicine and expert on health care policy.
“I believe the future for electronic health records is bleak because of poor incentives…”
The sad fact is that EHRs do not exist to facilitate good patient care; they exist to facilitate milking the Medicare and other third-party payers for all they’re worth. They will continue to be clunky, burdensome systems that hide the relevant clinical information amidst a large amount of auto-populated nonsense.
However, there are some EHR systems that are explicitly designed for cash-only medical practices, such as Atlas.MD. These systems, free from the incentive to leech as many Medicare dollars as they can, will likely improve over time as users give their feedback and a market process results in improvement across the industry. These systems will likely be in the private officers of doctors who accept only cash. Don’t look for these in the office of a doctor who accepts Medicare, or in a hospital.
Megan Meade works as an EHR Publishing Specialist at Software Path, a platform which combines the latest thinking, news, and research on software.
“Technological advances in the healthcare industry enable smarter predictive analytics leading to improvements in preemptive healthcare…”
In the future, we can expect wearable technology to increase the accuracy of data and inform future healthcare decisions through smart integrations with EHR systems. Wearable technology is expected to advance a practice’s ability to spot potential problems before they become symptomatic, and we can expect this technological advancement to improve patient care and experience.
Dmitry Garbar is a partner at Belitsoft, a custom software development company with a focus on the healthcare domain. He has been working in IT for over 11 years, first as a developer, then in project management roles.
“I think that new technology has a chance to improve the things EHRs get a lot of flak for…”
Firstly, improved voice recognition and artificial intelligence could streamline the tedious data-entering. There is definitely something wrong with the fact that physicians spend two hours doing clerical tasks for every hour they spend with patients.
Natural language processing and big data sorting algorithms could also help on a larger scale. The anonymous data could be processed to improve diagnostics, provide valuable information to pharmaceutical companies, and help doctors speed up their work with patient records.
EHRs will become better at what they were created for – making a doctor’s work easier. With better speech recognition, the clinicians will spend less time typing and clicking on dropdown menus. Talking to the EHR would be enough to enter the necessary information, and it will allow medical professionals to concentrate on helping patients. AI-powered virtual assistants will quickly find the requested information, order medication refills, and do other routine work, freeing doctors and nurses from clerical tasks. Integration with wearable devices will increase the volume of the available health-related data, and Big Data analysis algorithms will help gain meaningful clinical information from it.
Michelle Katz, LPN, MSN is the CHIO and Senior Vice President of F1 HealthIT. She is also the Author of Healthcare for Less,101 Health Insurance Tips, and Healthcare Made Easy.
“I am seeing a LOT of companies trying to…”
Get around the interoperability and trying to use the cloud without violating HIPAA. This has been a challenge to most, especially since HIPAA is not understood by most in the IT space that I deal with. Keep in mind that HIPAA was originally put in place to protect health care coverage for individuals who lose or change their jobs.
In addition, there is new technology coming out to give patients control of their medical records. Google tried a version of this years ago, but it failed. There are other companies that are working on this, especially now that there is a big push for healthcare to become more patient-centric.
“We’ve worked extensively with numerous health care organizations including Qualis DME Management and Hospice of Michigan, and what we’ve seen over the years is a huge push for standardization…”
A long overdue push for standardization, I might add. With APIs like FHIR, companies are much more able to transmit records between each other, which is a huge boon for the industry.
And as standardization becomes ever more important, everything will become electronic. Issues such as secure storage and secure transmission are being rapidly solved (or are already solved), so a lot of the hurdles to full electronic record-keeping are fading. So in 5-10 years, those paper records will be shredded, patients will have better access to their electronic medical records, and the whole system will flow much more smoothly and efficiently as everything becomes even more (or even entirely) digital.
Alexandra Zelenko is a Marketer and Technical Writer at DDI Development, a company that provides great web and mobile digital solutions.
“As many people already know, EHR data is frequently the target of hacking…”
That’s why the healthcare industry is projected to spend $65 billion on protecting sensitive healthcare information by 2020, according to data from CyberSecurity Ventures. According to a study conducted by IBM, around 16% of healthcare executives are determined about their plans to implement blockchain solutions in their work this year, while approximately 56% expected to adopt blockchain by the year 2020.
Hackers can obtain other valuables or adopt a false identity when stealing someone’s personal information. Blockchain can help prevent that by using a very advanced form of cryptography – it takes a list of records and adds to it with each transaction. Computers calculate the next link in the blockchain and ensure that the ledger is complete before moving on. The chain of records gets longer over time, and the cryptography behind blockchain is incredibly difficult to break. This makes it virtually impossible to steal information or make unauthorized changes to the data. Utilizing blockchain solutions, healthcare organizations can manage patient information and promote value-based care by sharing EHR data securely, according to exact rules.
Sean McSweeney is the CEO of Apache Health, a firm putting together specialty specific predictive analytics for better information in the business of healthcare.
“While most of the focus on the future of electronic medical records, or EMR, is about clinical opportunities…”
There will also be radical changes with respect to the incorporation of finance into the EMR. While historically the emphasis has appropriately been on determining clinical care, independent of cost, and physicians have wanted to stay far away from the perception by patients that they are involved in money, this isn’t sustainable. There is little point in ordering a test that the insurer will not authorize or will refuse to pay. This just creates clinical and administrative headaches as patients need to get new tests or medications ordered that will actually be covered. As our system moves towards a cash pay system with catastrophic coverage, patients will increasingly demand to know how much it will cost for each procedure, test, or medication ordered at the POC and want to be integral to the selection process as cost becomes a consideration. This means pricing data as well as instant eligibility or benefits verification will be required. Truly sophisticated systems that employ machine learning or artificial intelligence will be able to predict the likelihood for success of a pre-authorized or payment by the insurer and what the balance will be that is owed by the patient. We can even envision a future where patients will evaluate services based on probability of success of the treatment combined with the cost in order to get a relative value comparison.
Ian Khan is a 3xTEDx Speaker, @Forbes @CNN Featured Futurist, and Author & Creator of 7 Axioms of Value Creation. He’s been quoted in Forbes, CIO, TalkinCloud.com,CTV News, Global News, MarTechToday, and Gulf News. Ian is a member of World Future Society, Association of Professional Futurists, and National Speakers Association.
“Traditional health records will transform into…”
Information available on secure private blockchains, giving owners unprecedented preferences on how that information is used, who accesses it, and which parts of the information they access. As emerging technologies, including blockchain, help create a fully traceable and accountable way of creating records and storing information, the EHR industry should be the first to benefit.
Nir Kshetri is Professor at University of North Carolina-Greensboro. He has authored nine books, four of which are in the area of cybersecurity, including Cybersecurity Management, to be published by The University of Toronto Press in 2019. One of his books has been selected as an Outstanding Academic Title by Choice Magazine.
“All access to healthcare data should be monitored and logged…”
Unmonitored access to identifiable information should not be allowed. It may not be realistic and feasible to achieve this goal for current EHR models yet. In many healthcare organizations, mechanisms do not exist for assuring that patient data are not accessed by unauthorized users. The current EHR infrastructure may not meet patients’ privacy demands.
The above challenges can possibly be addressed with blockchain. Blockchain can solve the broader problem of systems relying on password-based security and authentication. The blockchain ledger includes an audit trail and data that are time-stamped, which allows the patient to know (within reason) who made what changes and when. Third parties such as healthcare providers can see the patient’s data with their permission, but they are not required or expected to store the data. In this way, a blockchain-based model is superior to existing data governance models.
Blockchain initiatives have already been undertaken by governments and the private sector. There are also public-private partnership (PPP) projects. As an example, the Food and Drug Administration (FDA) and IBM Watson Health teamed up to investigate the potential benefits of blockchain in healthcare. Initial effort will focus on oncology-related data and a blockchain framework.
Blockchain enables the collection of data from a variety of sources and keeps it in an audit trail of transactions. Blocks hold transactions and other data. Accountability and transparency of transactions is achieved in this data exchange process. FDA and IBM believe that blockchain can support the exchange of data from multiple sources on agreed to terms and for purposes that a patient approves and agrees to. They include EHRs, clinical trials, genomic data, and information gathered from new sources, such as mobile devices, wearables, and IoT devices.
Ted Chan is the CEO of CareDash, a healthcare provider directory with over one million patients searching for doctors every month.
“To me, the future of the EMR will be…”
Increasingly API-driven, moving us towards healthcare as an extensible, developer-friendly ecosystem to drive innovation. This will allow developers at health systems and external innovators to build powerful applications and analytics quickly. Though this has been talked about for some time, I truly think we are through the inertia in healthcare and enterprise software, because those that do not permit open innovation will fall behind in their ability to drive value.
Marty Puranik is the President and CEO of Atlantic.Net, a web hosting solution that provides HIPAA-Compliant, Managed, Dedicated, and Cloud hosting.
“Health records have come a long way in the transition from paper to computers…”
With the latest advancements in health information technology, access to electronic medical records is becoming easier and faster, but it comes with its own evolving challenges. Secure cloud promises to solve a lot of those challenges, but there seem to be continual changes as technology evolves. There are now mobile applications coming out with distinct features, in addition to teleclinics. There is still a lot of work to be done to continue to integrate and secure records. You can call it a work in progress but at the same time, it has to be available, compliant, and secure.
Jamie Cambell previously work with Cyber Security at Google.He has a Ph.D., M.S. in Computer Science at the University of California, Berkeley. Jamie currently runs GoBestVPN, an educational site on VPNs and protecting digital privacy.
“It’s crazy to believe HIPPAA was passed more than 20 years ago and still holds today…”
There are legal decisions being made, but most are rather reactive to advancements in technology. Come 2009, and the HITECH Act rolls along that seriously addresses a major issue: data protection and reporting breaches. The government also incentivized good behavior, such as getting organizations to use EHRs.
Today, there are more data breaches and leaks than ever. In 2018, there were billions affected by hacks and breaches from public and private companies. These two major laws were implemented around a decade apart. If this trend continues, we may be up for a new law addressing the security around patient data.
Sami is a CEO at a digital health start-up, Medzino. He is passionate about how tech can be used to benefit the patient and the companies which serve them.
“Traditional EHR systems will eventually become too costly and inefficient to use…”
Patient demands are changing, and tech has evolved the way patients now interact with health professionals. With a growing demand for efficiencies in every business due to squeezed budgets, a simple solution will arise with a mission to combine all the different EHRs into a single platform using a tech solution such as Restful APIs. Patients, doctors, PBMs, and insurance outfits will all securely exchange data instantly and securely, helping all components of the healthcare system run in sync.
Linda Hamilton is the OFAC Compliance Officer at Proven Data.
” As more hospitals and healthcare providers implement technological advancements as part of their data management systems…”
There will be more uncertainty regarding security of these health records. This issue needs to be addressed on an industry-wide level to begin filling in the vulnerabilities for cyber criminals to take advantage of. There is some progress being made with the wider adoption of HIPAA (Health Insurance Portability and Accountability Act); however, there is much progress to be made. I believe once the industry devises a more widely accepted, holistic approach to the security of these records, then the progression of AI (Artificial Intelligence) and technological advancements will flow into the business model. Security professionals and healthcare leaders are already collaborating to create more secured environments for the ever-growing healthcare data pool. The future of healthcare records is both exciting and uncertain given the current climate of cyber security and the growing threat landscape of digital attacks.
Gordon Murphy, PhD
Gordon Murphy, PhD is the Managing Director of Pharma Analytics Ltd., where he brings new depth to pharmaceutical strategy consulting through analytics and automation.
“As healthcare technology advances, the EHRs will…”
1. Become larger. As technologies such as wearable tech begin to track patients in real-time, the volume of data for common measurements (e.g. blood pressure) will expand rapidly.
2. Grow deeper. Technologies such as genomics and transcriptomics can provide detailed information on patient states. As these technologies become cheaper, and more work is done on biomarker strategies, these can add great depth to patient data.
3. Become more accessible. EHR access is still a concern when patients move provider or location. The future of EHRs would likely allow secure permitted access without geographic boundaries.
It remains to be seen whether the investments for this data to be properly captured as part of EHRs will be made, or if just the outputs of these processes will be captured. EHRs will need to be able to track and store this data, while maintaining clarity. Sophisticated analytics systems would then be required to make this useful to physicians and to alert for rapidly deteriorating circumstances.
The future of EHRs will require better and faster systems. Analysis and visualization needs to be automated in order realize the value of healthcare technologies and improve care management. Other healthcare technologies, such as machine learning (or AI), can be used to discover patterns in aggregated patient data. The combination of larger, deeper data and the health outcomes already present could present exciting opportunities for drug and biomarker discovery.
Christina D. Warner
Christina D. Warner initially joined Walgreens Boots Alliance in 2018 and help grow the provider marketing pull-through initiatives and implementation process. Before Walgreens Boots Alliance, Christina joined Northwestern Feinberg School of Medicine. Christina also worked in an international trading firm, spending her time equally between Taiwan and China. She is a writer for Authority Magazine and Arianna Huffington’s Thrive Global.
“The idea of the future of healthcare is very exciting! I believe with technological advances, EHR systems…”
Will look very different than they do today.
1. Currently, there is a lot of push and popularity and focus on genomic data and research, which can ultimately led to personalized treatment (or precision medicine). So, what Sandy needs is very different than what Bobby needs to treat asthma. EHR systems can be a key in collecting, storing, and interpreting that data to create highly effective, customized and personalized treatment.
2. Ultimately, there are several aspects at play. First, genetic data can lead to precise medication treatment. The EHR can help collect that data, store it and follow HIPAA regulations, and leverage ‘big data’ to create accurate treatment, or predict high risk population.
3. Existing examples:
- Veteran Affairs Department has enrolled 500,000 veterans to create one of the largest genomic research databases.
- Illumina, a Gene-sequencing giant corporation, was highlighted by Motley Fool, and sells its products for $1 million per machine (this shows a strong market demand).
- MarketWatch reports that personalization of medicine could be worth 149 billion by 2020.
Kate Monti is the Head of Operations and Account Success at Workit Health, an addiction healthcare company offering online evidence-based addiction treatment including telehealth medication for opioid use disorder. Holding masters degrees in Social Work and Public Health, Kate is passionate about transforming care delivery to increase access to evidence based treatment services.
“The healthcare field is moving rapidly towards a model that…”
Puts medical information into the hands of patients via online portals, apps, and telemedicine treatment. The distance between a patient and their medical record is smaller than ever. As immediate access to medical records becomes as simple as ordering a pizza, changes requested to medical records will likely increase and patients will expect that making those changes to be as easy as accessing their information. Here at Workit Health, we have designed a patient and provider integrated electronic health record to empower patients to make medical decisions about their care quickly and easily – from signing consents, ordering more medical supplies, and communicating with their care team.
Electronic health records will be required to move away from their historic function as a tool for providers or health systems. Instead, companies will be expected to develop electronic health records that provide integrated interfaces for both providers and their patients to access information and communicate. Care decisions made between a provider and a patient using these platforms will quickly become a requirement and expectation in the health field, rather than an innovation of new and upcoming health companies.
Dr. Jason Reed
Dr. Reed has worked in the healthcare IT space for over 16 years. He has worked with various EMRs, networks, and large PBM payers, providing connectivity and interoperability among the various entities in the space. He has a deep passion for using technology to enhance clinical products and processes that advance healthcare. His blog, BestRxForSavings.com, is focused on his work as a Patient Medication Advocate.
“Electronic health records are now ubiquitous following the…”
Huge amounts of money that government programs paid out via meaningful use. With the availability of use within reach of almost all prescribers in the U.S., the future of EMRs is full of promise. In a healthcare landscape, the still very siloed EMRs will be the framework to allow sharing of patient data. EMRs will be the hub for patient data repositories that will allow capture and transfer of patient data across a lifetime, from pediatric doctors to family practice, specially providers, and on to geriatrics. Healthcare records for patients will move with them and will be tied together with other ancillary healthcare services they receive all via EMRs.
The most likely way this interoperability will occur is via FHIR messaging over open APIs. Challenges exist, such as the need to help uniquely identify patients, but the time has come where the public is ready for data access.
The EMR of tomorrow will also serve as the patient interface as well. This started as patient portals and is now evolving into mobile applications. The future will see EMRs’ connectivity being the key interface for everything from scheduling and follow ups, to communication interfaces and telehealth. The future of EMRs is dependent on connectivity across a broad array of connections with large data sharing organizations, standards bodies, and health information exchanges. The EMRs who are on the forefront of this will come out on top.
David S. Williams, Founder & CEO of Care3, is a digital health entrepreneur and thought leader in healthcare communications. David focuses on reducing health disparities for underserved groups including seniors, people of color, the disabled, and the poor. He was previously Founding Chief Marketing Officer and Head of Business Development for digital health unicorn, PatientsLikeMe.
“Whether the incumbent EHR companies know this or not…”
They are in danger of becoming relegated and commoditized in the next decade because of their intransigence in embracing interoperability, combined with the shift of Medicare and Medicaid dollars to home and community-based care away from hospitals and long term care facilities.
This shift in setting based on the exorbitant care costs within facilities requires new data and information that current EHRs do not support. While it’s true that EHRs will likely remain the systems of record for most healthcare organizations, the successful legacy EHR systems will build or acquire capabilities that support home and community-based care. In the short term, they should embrace interoperability and work with vendors such as Sansoro to enable easy pathways between legacy and emerging platforms.
Mira Violet is a Software Developer for Amethyst Design.
“The biggest and most exciting thing about advancements in electronic health records is…”
Data sharing across regions. Imagine if you could look at an accurate map that shows any and all disease reports? Imagine being able to accurately avoid areas with high counts of measles cases, or the flu? Imagine having the ability to stop abusers from moving to a new state where there’s no medical record of abuse? Imagine being able to use massive amounts of data to accurately determine what diseases occur at a higher rate in more polluted areas? The innovation that this kind of mass collaboration will bring is going to revolutionize medical research.
Tracey S. Lawrence is co-founder of Optimum Health Society LLC and author of Dementia Sucks: A Caregiver’s Journey – With Lessons Learned (2018, Post Hill Press). Having been caregiver to two parents who succumbed to dementia, Tracey has a unique perspective on the issues surrounding caregiving and the challenges of staying healthy and productive under extreme pressure.
“EHR today is fraught with challenges…”
Currently, there is no standard format, so every provider visited has their own set of data on the same patient. Privacy concerns keep the information isolated. By standardizing a format for the data collected in a secure, blockchain framework, my partners are working to enable the unification and exchange of EHR so healthcare consumers can have control over how their data is shared, and a more comprehensive, holistic approach to care may be implemented.
Jennifer George is an inpatient Physiotherapist, former caregiver, and forthcoming author of Communication is Care: 9 Empowering Strategies to Guide Patient Healing.
“With advances in health technology…”
I imagine that communication inter-professionally will become more fluid and seamless. It will enhance communication among the healthcare team as documentation will be captured as events occur so that all staff on an inpatient unit can receive current and real-time information on shared patients. Furthermore, it will create efficiency in sharing patient files with outpatient clinicians, which may further save patients the burden of having to repeat the events of their history and reason for referrals repeatedly.
Stephen Matthew Arndt is the President of Silver Linings Technology, a national healthcare information technology consultant and industry leader. Stephen is an innovator, change agent, and problem solver who focuses on results. Stephen has spent more than 25 years in IT, specializing in healthcare for more than 15 years.
“According to a report put out by the FBI…”
Cyber criminals sell EHR information on the black market at a rate of $50 per record, compared to $1 for social security numbers or credit card information. Why are they more valuable? Because the theft is more difficult to detect.
Criminals can use this personal information to file fraudulent insurance claims or obtain prescription medication. They can take identity theft to a whole new level and let the rewards play out indefinitely.
Credit cards can be canceled. It’s more complicated to resolve medical identity theft.
One way to counter criminal behavior is to have a detection plan in place. Audit logs will capture data elements such as date and time accessed, as well as user stamps for each access and update made. By keeping a watchful eye on these logs, you can monitor behavior and look for inconsistencies and patterns. When you notice something that doesn’t seem quite right, you can take action right away.
Ilia Sotnikov is an accomplished expert in cybersecurity and IT management, VP of Product Management at Netwrix, provider of a visibility platform for data security and risk mitigation in hybrid environments.
“EHR systems may revolutionize tremendously within several years to…”
Completely replace paper-based work, centralize patients’ data, and improve the quality of care, but one thing will remain the same. Healthcare organizations will keep struggling to ensure adequate privacy and security measures for the EHRs. On the one hand, they must ensure that health data is available to all authorized personnel for efficient care processes and care coordination. At the same time, this will require controlling all activity around health data to avoid privilege elevations, suspicious data modifications, information disclosure, and other potentially harmful events in time. On top of that, with tremendous amounts of data created, the need to classify data for more efficient and secure use by healthcare providers will become acute.
With this in mind, clinicians should be ready to layer advanced data protection solutions, such as data discovery and classification, DLP, endpoint protection, multi-factor authentication, and encryption over basic yet efficient security measures. Also, we may expect greater integration of hospital EHR systems with third-party security software.
Chrissa McFarlane is the Founder and CEO of Patientory, Inc. Today, McFarlane leads Patientory, Inc. in its product development and works on behalf of the Patientory Association, a global not-for-profit dedicated to advancing new technologies in healthcare. She also serves as co-chair of the healthcare industry’s HIMSS18 Blockchain Workgroup.
“One of the biggest priorities when it comes to medical data is…”
Security, so much so, that the Affordable Care Act federally mandates how providers store and transfer digital health information. Patientory goes one step further by building their app’s software on blockchain technology. This foundation enables full HIPAA compliance on one of the most secure platforms available, so the only people who can access medical data are those that are authorized. Patientory app’s innovative features and design empowers users to take ownership of their medical information, and how it’s shared in the digital age. By improving patient-provider collaboration to be more secure and simple, Patientory is making medical records more useful for everyone.