Electronic Health Records (EHR, EMR)

Despite a flurry of innovations and technologies for healthcare cropping up on the market, their use and deployment remains fragmented across the world, with barriers around poor access, a lack of interoperability and challenges in embedding these tools into workflows continuing to hinder progress. When looking at citizens’ attitudes, however, new research commissioned by Philips indicates that people would be more likely to use digital health technologies if they were recommended by a healthcare professional and if they had an “assurance” that their data would be kept secure. Furthermore, according to the study, being able to share the information tracked with healthcare professionals also plays an important role in the decision to use digital health tools, as well as their affordability. WHY IT MATTERS The Philips 2019 Future Health Index, published earlier this month, aims to provide an insight on the impact of digital technology based on a survey of 15,000 citizens and over 3,100 healthcare professionals in 15 countries (Australia, Brazil, China, France, Germany, India, Italy, the Netherlands, Russia, Saudi Arabia, Singapore, South Africa, Poland, the UK and the US). Findings indicate that over 75% of the hospitals and practices where the professionals surveyed worked were using digital health records. However, challenges in deploying EHR systems were still reported, and the “common assumption” that digitisation could add more tasks from an administration standpoint to people’s jobs was also quoted in the research.  In addition, survey results show that 80% of professionals were able to share patient information electronically with colleagues in their organisations, but only 32% had the ability to exchange data with professionals from other facilities. This was due to a lack of access to data sharing systems, interoperability, concerns around privacy and security, as well as a preference for using paper or phones instead.  Meanwhile, 36% of citizens said they “regularly” shared health data tracked by using digital tools with the professionals caring for them, and that these provided "convenient" access to services and helped them feel “more in control” of their health.  “Two-way sharing of information is not only essential to deliver the right care at the right time, it also helps to improve the patient and clinician experience,” said Jan Kimpen, Philips chief medical officer. “Informed and empowered patients also take better care of their health, which contributes to the last element of the Quadruple Aim – lower cost of care.” ON THE RECORD Looking at a country breakdown, the researchers said China, Saudi Arabia, India and Russia were leading the pack when looking at the use of emerging technologies to ensure people remained healthy and improve the care delivered to patients.  “We know from the previous three editions of the FHI [Future Health Index] study that it is hard for countries with a developed healthcare system to change, simply because of the legacy,” Kimpen added. “So we should learn from countries with an emerging healthcare system that have leapfrogged in the adoption of digital technologies. Technology is no longer a limiting factor, the important thing for all of us is to be prepared for change.”  WHAT'S THE TREND In the 2018 study from Philips, researchers noted that adoption could be accelerated through education, after findings indicated that only 47% of the healthcare professionals and 24% of individuals surveyed said they felt “knowledgeable about connected care technologies”. They also called for both professionals and patients to be involved at earlier stages when developing solutions in order to help “secure buy-in”.

The HIMSS EHR Association tells the Centers for Medicare & Medicaid Services that the Promoting Interoperability Program needs consistency and specificity in its clinical requirements.

During the ‘Promoting the implementation of electronic health records’ Seminar that took place in Ho Chi Minh City, Vietnam last week, the Ministry of Health announced that Electronic Health Records (EHRs) will be deployed nationwide from July this year. WHAT’S THE IMPACT “The collection of health information will help the Vietnamese manage their health better. This will also raise their self-awareness of disease prevention and the potential risk of diseases affecting health and life,” emphasised Nguyen Truong Son, Deputy Minister of Health, Vietnam. From the doctors’ and caregivers perspectives, the deployment of EHRs will be an important tool in the prevention and treatment of diseases for the community. The availability of EHRs will also prove invaluable in helping the decision-making processes of doctors, especially during emergency cases in which time is of the essence. Currently, there are 24 provinces implementing EHRs in Vietnam, of which 6 are officially considered as the 'piloting EHR provinces'. The 6 piloting provinces met in Hanoi on June 13-14 for a workshop to share their learning experiences and for further planning. “The EHRs will be the basis of a national health data system as each citizen from birth to death will be granted a social insurance code. The construction of medical identifiers based on social insurance codes almost never misses anyone, except for citizens who are born but for some reason, have no birth certificates,” said Associate Prof. Dr. Tran Quy Tuong, Director of the Information Technology Department, Ministry of Health, Vietnam. LONG TERM PLANS “In order to achieve the goal of 90% of the population being managed for health by 2025, the Ministry of Health is urgently working towards the implementation of EHRs,” said Deputy Health Minister Nguyen. The Health Ministry has already approved the application of IT at commune and ward health stations in the period of 2018-2020. The Ministry of Health has numerous policies based on the EHR and data and health information standards – more specific guidelines, especially those around interoperability, will be issued in the coming months. 

Severance Hospital, one of the oldest and biggest university hospitals in South Korea, has signed a Memorandum of Understanding (MoU) with Korean startup MediBloc to build a blockchain-based medical information platform.  Based on the MoU, MediBloc will build the medical information platform, an insurance claims billing platform and a medical data forgery detection system to facilitate the sharing of medical information via individuals. Severance Hospital plans to establish a certificate document issuance system and e-card issuance system for patients. Both parties will also cooperate actively by jointly utilising their facilities, human resources, and cooperation networks. THE LARGER TREND Last November, Korea’s Myongji Hospital signed an agreement with BICube to co-develop a blockchain-based medical information exchange. Both parties plan to commercialise the blockchain-based service by 2019. In December 2018, Massachusetts General Hospital in the US announced that it will be working with MediBloc on a three-year blockchain pilot to co-develop new methods for security and interoperability, with a focus on patient engagement. ON THE RECORD “We are delighted to build a patient-centred platform with MediBloc, which is leading the blockchain-based medical information platform,” said Lee Byung-seok, General Director, Severance Hospital in a statement. “By working with MediBloc, we will be able to provide personalised medicine and digital healthcare to patients at Severance Hospital through the establishment of an integrated medical information system.” “We will continue our comprehensive consultation for building a platform with Severance Hospital, which is recognised for its excellent medical team and service,” said Allen Kho, Co-CEO, MediBloc. 

Established firms have good track records, but there are high-performing developing companies, too; as providers tackled bigger strategic initiatives beyond mere EHR rollouts, they need to weigh how much they value experience and performance, a new report shows.

And benefits extend into areas it has not yet been able to quantify. For instance, the physicians group anticipates increased savings created by the filling of appointment slots that more quickly opened due to the technology.

The Australian Digital Health Agency and the University of Sydney have partnered on a pilot program to assess how the My Health Record platform can improve the cardiology service. During the study, clinicians at Westmead Hospital will have access to participating patient's My Health Record, drawing on the information within the record to make a quicker diagnosis or decisions for treatment. Other goals of the pilot program aim to reduce duplicate testing and bolster support for communication among healthcare providers through the My Health Record shared healthy summary feature. A My Health record provides GPs, pharmacies and health systems with the ability to view a patient's health information securely online. It also allows healthcare providers involved in the user's care to view the person's health records, and health professionals can upload, view and share documents, diagnose and provide treatment. "Our study aims to provide greater accessibility to the information needed to better treat all Australians suffering chest pain, and to safely divert people with non-acute chest pain from being admitted to hospital," saif Clara Chow, academic director of the Westmead Applied Research Centre, in a statement published in the Australian Journal of Pharmacy. Heart disease was the single leading cause of death in 2018, with 170 Australians aged 25 years and over having a heart attack every day, Australia's Health 2018 report revealed last June. "Last month we discovered more than two-thirds of Australian adults have risk factors for heart disease," Heart Foundation general manager for heart health and research Bill Stavreski said in a statement. "Statistics like these remind us of the importance of looking after our heart health and My Health Record provides Australians with a place to store all-important records regarding your heart history and preferred treatment methods," he said. "We need all Australians to be aware of the prevalence of heart disease and the work left to do in improving our heart health," Agency CEO Tim Kelsey said in a statement. "This program is a great example of how we can use digital technologies to meet this goal and deliver better health outcomes to all Australians." Australian pharmacies and general practices are rapidly adopting My Health Record, the Government's digital health record system, according to the latest figures by the Australian Digital Health Agency. In the period between April 2018 and April 2019, there was a 13 percent increase in the number of shared health summaries uploaded by GP organisations and a 60 percent increase in the views of clinical documents by GP organisations. Digital solutions and technology has improved connectivity between patients and providers and brought Australia to the brink of a transformative phase in healthcare, according to professional services firm MinterEllison. A recent Melbourne Institute Health report also strongly indicated digital technology has the potential to bring doctors and patients together online through teleconsultations and shared electronic health records.

Officials from both companies say the collaborative platform could help healthcare professionals deliver more personalised information, with the aim of improving health literacy and supporting behaviour change.

Watch the stream of the Helsinki event's second day in its entirety, with discussions on pressing issues including interoperability and EHRs.

A natural language processing algorithm has been helping the New York health system gain new insights from its unstructured notes, boosting its value-based care and pop health efforts.