JAMA: National EHR network proposed
A commentary published by the Journal of the American Medical Association proposes ways in which the U.S. can affordably meet the needs and expectations of both the public and healthcare providers as an interconnected system of EHRs is developed at the national level.
In the commentary, Aviv Shachak, PhD, and Alejandro R. Jadad, MD, of the University of Toronto’s Department of Health Policy, Management and Evaluation provide ideas for U.S. health IT professionals and policymakers to consider as they work towards a cheaper and more efficient national healthcare system that utilizes more fully developed EHRs.
Their proposal includes seven central concepts:
Promoting Health
The authors suggest that EHRs should not function solely as a tool that doctors use to treat patients, but also as a tool to promote public health.
“The concept of ‘patient-centered care’… acknowledges the multiple contexts of individuals’ lives and the web of relationships and interactions they have with the (social) environment,” the authors wrote.
Whereas early EHRs focused on providers’ need for information to diagnosis and treat patients, the authors believe that the next generation of EHRs should promote patient participation in self-care and encourage the development of functional health knowledge by allowing patients access to their own health information.
Interoperability
According to the authors, the development of standards to ensure interoperability of EHRs is an ongoing process that is currently occurring mostly at the local level.
Building enthusiasm for a system of nationally interconnected EHRs, the authors suggest, indicates that now is the time to begin developing global standards for interoperability.
The authors wrote that U.S. health IT policymakers should work with their counterparts in other nations to “harmonize all elements of the digital health landscape.”
Multimedia’s Potential
The data entry fields of most currently existing EHRs only allow for text entry, but the authors suggest that the incorporation of multimedia into EHRs could minimize the interference of data entry with communication.
“Rich multimedia has the potential to reduce ambiguity and enhance performance in complex tasks,” the authors wrote.
Despite the potential for multimedia use in EHRs, the authors note that there are legal concerns associated with its adoption and that the topic deserves research.
Opportunities for Interaction
The authors believe that the next generation of EHRs should foster communication between providers and patients across multiple mediums including text messaging, telephoning and videoconferencing.
“With the rapid convergence of the Web with mobile telecommunication devices,” the authors wrote, “it is now easy to embed resources in EHRs that support exchanges of information by members of the public with health care professionals in a wide range of modalities.”
Increased ability to communicate with providers, the authors suggest, would ease patients’ demands for immediate access to healthcare.
Social Networking
According to the authors, currently existing EHRs easily allow for one-to-one interactions between patients, providers and administrators, but that the national healthcare system could benefit from tools that allow for one-to-many, many-to-one, and many-to-many interactions.
The authors suggest that tools to enable different types of communication already exist in the form of social networks and that integrating resources available on social networks into EHRs would be a cost-effective means of enabling enhanced communication.
Improving Healthcare
The authors wrote that EHRs can be used to assess and improve the healthcare system as they are used to diagnose and treat individual patients: “EHRs could include tools that generate system-wide data with which to assess the performance of the health system as a whole, and to introduce and evaluate health services in real-enough time.”
Privacy Concerns
According to the authors, EHRs must perform two functions that are often at odds with one another: protect personal information while promoting the exchange of information.
“In healthcare, while privacy of information is absolutely essential, there are concerns that excessive preoccupation with privacy may interfere with the quality of service,” the authors wrote.
The authors suggest that a new balance between patients’ expectations for privacy and for quality care needs to develop in order for EHRs to function optimally.
In the commentary, Aviv Shachak, PhD, and Alejandro R. Jadad, MD, of the University of Toronto’s Department of Health Policy, Management and Evaluation provide ideas for U.S. health IT professionals and policymakers to consider as they work towards a cheaper and more efficient national healthcare system that utilizes more fully developed EHRs.
Their proposal includes seven central concepts:
Promoting Health
The authors suggest that EHRs should not function solely as a tool that doctors use to treat patients, but also as a tool to promote public health.
“The concept of ‘patient-centered care’… acknowledges the multiple contexts of individuals’ lives and the web of relationships and interactions they have with the (social) environment,” the authors wrote.
Whereas early EHRs focused on providers’ need for information to diagnosis and treat patients, the authors believe that the next generation of EHRs should promote patient participation in self-care and encourage the development of functional health knowledge by allowing patients access to their own health information.
Interoperability
According to the authors, the development of standards to ensure interoperability of EHRs is an ongoing process that is currently occurring mostly at the local level.
Building enthusiasm for a system of nationally interconnected EHRs, the authors suggest, indicates that now is the time to begin developing global standards for interoperability.
The authors wrote that U.S. health IT policymakers should work with their counterparts in other nations to “harmonize all elements of the digital health landscape.”
Multimedia’s Potential
The data entry fields of most currently existing EHRs only allow for text entry, but the authors suggest that the incorporation of multimedia into EHRs could minimize the interference of data entry with communication.
“Rich multimedia has the potential to reduce ambiguity and enhance performance in complex tasks,” the authors wrote.
Despite the potential for multimedia use in EHRs, the authors note that there are legal concerns associated with its adoption and that the topic deserves research.
Opportunities for Interaction
The authors believe that the next generation of EHRs should foster communication between providers and patients across multiple mediums including text messaging, telephoning and videoconferencing.
“With the rapid convergence of the Web with mobile telecommunication devices,” the authors wrote, “it is now easy to embed resources in EHRs that support exchanges of information by members of the public with health care professionals in a wide range of modalities.”
Increased ability to communicate with providers, the authors suggest, would ease patients’ demands for immediate access to healthcare.
Social Networking
According to the authors, currently existing EHRs easily allow for one-to-one interactions between patients, providers and administrators, but that the national healthcare system could benefit from tools that allow for one-to-many, many-to-one, and many-to-many interactions.
The authors suggest that tools to enable different types of communication already exist in the form of social networks and that integrating resources available on social networks into EHRs would be a cost-effective means of enabling enhanced communication.
Improving Healthcare
The authors wrote that EHRs can be used to assess and improve the healthcare system as they are used to diagnose and treat individual patients: “EHRs could include tools that generate system-wide data with which to assess the performance of the health system as a whole, and to introduce and evaluate health services in real-enough time.”
Privacy Concerns
According to the authors, EHRs must perform two functions that are often at odds with one another: protect personal information while promoting the exchange of information.
“In healthcare, while privacy of information is absolutely essential, there are concerns that excessive preoccupation with privacy may interfere with the quality of service,” the authors wrote.
The authors suggest that a new balance between patients’ expectations for privacy and for quality care needs to develop in order for EHRs to function optimally.