What Role Will Next-Gen EHRs Play in The Future of Health? | Deloitte US has been saved
By Christopher Harris, specialist leader, and Charles Talbot, manager, Deloitte Consulting, LLP
After decades of investment and optimization, electronic health records (EHRs) are ripe for disruption. Many EHR vendors appear to be positioning themselves for the Future of Health by moving to cloud platforms where they can tap into enhanced artificial intelligence (AI), machine learning, and automation to generate deeper insight into the health and wellness of consumers.
Efforts to transition away from paper health records began in the early 1960s. Lockheed Corporation is credited with developing the predecessor to the modern EHR in 1971. In the decade that followed, some academic medical centers developed their own variations, and the federal government implemented its Decentralized Hospital Computer Program for the Department of Veterans Affairs.
Today, about 96% of hospitals/health systems and 86% of physician offices have an EHR system. However, some of our hospital and health system clients wonder what the future might hold for EHRs given that current systems can constrain their ability to share data, integrate external data sets, or offer a more holistic view of their populations. They want to know if they should continue to invest in their legacy systems. At the same time, EHR vendors are trying to preserve their core customer base while positioning themselves for a future where early detection and prevention of disease are priorities.
Many health systems have made substantial investments in data and operations-management systems for EHRs, supply chain, and revenue-cycle functions. EHRs that serve as powerful workflow and analytics engines could be particularly important as health systems continue their march toward value-based care. However, the technology behind EHRs is complex and not always easy for some clinicians to use. Further, the technology and core workflows presuppose a model of care transactions required when a problem occurs, acute or otherwise. Hospital and health system leaders understand that it is difficult for an organization to transition to a new EHR platform. It takes time to get everybody trained and comfortable with a new system and new workflows.
COVID-19 might have sped the EHR evolution
The COVID-19 pandemic helped to accelerate the growth of digital technology and the adoption of virtual health. This, combined with broader disruptive trends in the industry, could lead to a new generation of EHRs that are consumer centric and able to streamline the workflow of clinicians.
The core feature of an EHR is to capture clinical documentation and generate charges. Those core capabilities don’t vary much from vendor to vendor, and they typically don’t lend themselves to improving wellness. The next step in the EHR evolution might be to tap into the data and use it to develop insight-driven analytics. The rapid growth of digital cloud-based technology, virtual health, and a growing focus on wellness could set the stage for a broader re-imagination of the EHR. Some EHR companies are migrating to cloud-based platforms and are partnering with various hyper-scalers to expand their capabilities, services, and offerings.
EHRs are moving to a platform
Oracle Corporation, a large database vendor, recently announced its plan to acquire Cerner Corporation, a health care technology company. The combined company will provide medical professionals with “a new generation of easier-to-use digital tools…and secure cloud applications,” according to a December 20, 2022 press release. This acquisition, along with platform-level partnerships among EHR companies, and growing interest from hyper-scalers, indicate a growing transformative trend…EHRs are likely evolving into a platform for care management and delivery that extends into wellness management.
What will it take for EHRs to evolve, and what might this mean for health systems? We see two potential paths.
- EHRs will transform into a consumer-centric platform that supports the empowered wellness of the consumer.
- EHRs will remain a physician-centric platform that optimizes for physician efficiency.
Maybe EHRs could be physician-centric and consumer-centric
EHRs are essentially repositories for health care transaction data. Many EHR vendors are looking for ways to pull usable intelligence from those repositories. They are developing tools that analyze and interpret the data and provide actionable insight to physicians. Future EHRs will likely be able to apply artificial intelligence (AI), machine learning, and automation to extract insights that can improve care. This will likely require EHRs to be re-imagined as cloud-native platforms with data sets that are easily, securely, and safely interoperable. Third-parties will likely provide the AI tools, machine learning, and automation needed to make sense of existing and growing data sets. However, it is precisely this re-imagining of the EHR that represents possibly the most significant investment and risk for current EHR vendors. They risk losing customers due to enforced platform changes/upgrades. However, many health systems do not want to take on the disruption, risk or costs that would be needed to make a wholesale change.
Will EHRs transform into a consumer centric platform? Absolutely. We believe the consumer is going to become increasingly more responsible for his or her care decisions and will be able to tap into analytics generated by next-generation EHRs. In the future, consumers will likely use personalized health data to make medical decisions. This transition to the cloud could also set the stage for enhanced interoperability to receive and interact with wellness data generated by consumers. More accessible, interoperable data that can be used outside of the traditional EHR boundaries could be the differentiator for the next generation of EHRs.
