Reinventing and moving beyond the EHR. The proof is all around us.


HealthITNews reports that at least one popular EHR vendor (eClinicalWorks) is launching the flagship version of its cloud service solution by saying, "Don't call it an EHR". Perhaps we shouldn't be surprised by that as the latest EHR satisfaction survey from the AMA and Medscape shows that while EHR adoption by physicians has surpassed 80 percent, clinician satisfaction with EHRs over the last several years has plummeted.

Although widespread physician frustration and dissatisfaction with electronic health record solutions isn't a good sign, the effect it is having on both vendors and healthcare organizations is pushing much needed change and innovation in the Health IT industry. It has also become a stimulus for many large health organizations to take matters into their own hands and develop new solutions around their existing EHR systems that better meet the expectations of clinical end-users while also improving patient care.

Perhaps the latest example of this is an announcement today by Johns Hopkins University School of Medicine. Johns Hopkins and Microsoft announced plans to work together to redesign the way medical devices in an intensive care unit (ICU) talk to each other. The two organizations plan to develop a health IT solution that collects data from different monitoring equipment and identifies key trends aimed at preventing injuries and complications that can result from medical care.

Several months ago at an executive briefing in Redmond, Dr. Peter Pronovost, senior vice president of patient safety and quality for Johns Hopkins Medicine, showed those of us attending the work his team had done in a pilot program called Project Emerge.The program uses technology to restructure a hospital’s ICU workflow in an effort to eliminate the most common causes of preventable harm and promote better patient outcomes. It focuses not only on eliminating medical complications in the ICU, but also on common emotional harms to patients such as lack of respect and dignity.

Dr. Pronovost demonstrated a tablet-based application that coordinates and integrates all data from all monitoring equipment and information systems. Rather than scavenge medical records, devices and other sources to ensure patients receive all the appropriate care, clinicians can use the tablet app to quickly see all data in one location. A patient version of the application dashboard can be used by the patient and his or her family members to ask questions directly to the medical care team, provide details about their care goals, and learn more about each of the machines and monitors in the ICU room.

Now, in collaboration with Microsoft, Johns Hopkins plans to build upon the success of Project Emerge and make the solution even better for clinicians and patients in intensive care environments. Johns Hopkins will supply the clinical expertise for the build, while Microsoft will provide advanced technologies, including Azure cloud platform and services, as well as software development expertise. Using Azure, the improved solution will collect and integrate information from several modern devices and provide critical analytics, computing, database, mobility, networking, storage and Web functions. The final product will allow physicians to see trends in a patient’s care in one centralized location and let them access critical patient information from any hospital-approved, Windows device.

Another example of an institution that is working with Microsoft to move beyond the limitations of the EHR is Dartmouth Hitchcock. I told that story in an earlier post here on HealthBlog. Dartmouth-Hitchcock, through its ImagineCare initiative is setting a new standard of care by using cloud computing and advanced analytics for population health management. By freeing data that has traditionally been locked inside the EHR and blending it with data coming from multiple other sources both within and outside the enterprise including the patient's own home, ImagineCare strives to deliver better quality of care, improved access to care, and lower costs.

Getting back to the "Don't call it an EHR" comment from eClinicalWorks, I'd say that is exactly what is happening on many fronts today as EHR vendors, and so many of their customers, have come to understand there is much more to be done on the journey to digital health and care. It is absolutely an honor to work with prestigious partners and health organizations such as Dartmouth-Hitchcock and Johns Hopkins, as well as so many others around the world, on this critically important mission to improve health and healthcare delivery.

Bill Crounse, MD    Senior Director, Worldwide Health                 Microsoft  

 

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