Electronic Health Records (EHR, EMR)

Despite one senator's hope to move deliberately with rulemakings and not repeat some errors of meaningful use, National Coordinator Donald Rucker said delays only lengthen the time that consumers are "not in control of their care."

Company says the security flaw has not been exploited yet and urges customers to update to most recent version.

The global electronic health record (EHR) market size is proliferating, with Australia contributing to a large portion of that growth. According to a report by Global Market Insights, the EHR market size in Australia was valued at US $526.3 million in 2018 and is expected to witness over 8.5 per cent in exponential growth rate (CAGR) from 2019 to 2025. Australia’s EHR market size growth contributes significantly to global numbers expected – Global Market Insights estimates this to be US$38 billion by 2025. Global Market Insights report authors Sumant Ugalmugale and Ajay Devgire said the healthcare system in Australia is equipped with the necessary infrastructure to launch a national EHR program as 85 per cent of Australians and over 95 per cent of general practitioners have access to the internet. “In addition, healthcare associations such as the Royal College of Australian General Practitioners, the Pharmacy Guild of Australia and the Australian Healthcare and Hospital Association (AHHA) believe that adoption of EHR systems will reduce cost and improve safety, quality and efficiency of healthcare in the country,” they said. “Government initiatives such as My Health Record, aimed at maintaining the health records of all the Australian citizens will also drive growth of various digital health systems platforms in the country.” However, they warned that the potential threats for data breaches and privacy leaks will continue to impede the Australian EHR market growth over the coming years. On a global scale, the report identified that numerous emerging countries are recognising the importance and benefits of EHRs and are increasingly investing in such technology. “EHR offers enhanced patient care and management along with significant cost savings. EHR assists the practitioner in management of patient data and streamlines workflow that should positively impact EHR market size,” the authors said. Specifically, the web/cloud-based EHR software product market is expected to have large uptake. It was valued at US $12.5 billion in 2018. “Web-based EHR provides improved speed and flexibility to the end users in terms of its operability,” the authors said. “Access to many users simultaneously and wide network access further adds to the advantages of cloud-based EHR software. Moreover, web/cloud-based EHR software considerably saves cost that should escalate its adoption over the forthcoming years.” [Read more: Opinion: Is there a smarter way for the controversial My Health Record system? | Monash Health and SCHS commence EMR rollouts] In addition, the patient management segment of the EHR market is estimated to progress at six per cent CAGR during the forecast timeframe. “EHR offers systematic and timely scheduling of patient data. It enables safe and reliable documentation with time-effectiveness. In addition, the flexibility of management of vast data points regarding the patient will offer momentous growth opportunity for patient management EHR application market,” they said. The authors also identified that clinics’ EHR usage accounted for more than 17.5 per cent in revenue share in 2018. “EHR provides seamless access and interface for clinic facilities at any location. Presence of clinic management software further enhances patient and practice management that will drive its adoption rate clinics over the forthcoming years. Furthermore, expanding healthcare infrastructure across emerging nations will increase clinics EHR end-use segmental size in the upcoming years,” they said. However, according to the authors, along with the strong growth rate of EHR, there will also be a lack of skilled professionals to handle the sophisticated technology. As such, they urged the healthcare industry to prepare for this change.

The research firm says 2018 was the busiest in recent years for EHR market flux, and recent purchasing decisions show an evolution in the electronic health record landscape.

Having an EMR system brings to a healthcare organisation an integrated system. However, it may not suit individual department needs or workflows, an industry expert has warned. Speaking at the recent Australian Healthcare Week in Sydney, Sydney Local Health District Assistant District Director of Pharmacy and CPIO Rosemary Burke said in the chase to adopt EMR, many organisations end up having multiple electronic systems within an organisation. “Do you go for a best-of-breed system where the functionality is tailored to the environment where it is working, its business needs and workflow for a fairly easy for user adoption?” she questioned. “But then it gets challenging when you have a number of silos within an organisation, in addition to the silos that exist between the hospital sector and the community sector. Terminologies and functionalities can be different as well, so it can be very confusing.” According to Burke, many healthcare organisations traditionally went with best-of-breed systems as automation of care and electronic systems were about creating electronic health records and providing comprehensive views of patient data. But going forward, Burke stressed the need for systems that all talk to each other, address data leaks and provide analysis of patient data. “The use of multiple systems aren’t usually strategically planned. Some are led by clinicians, while others are led by the organisation. And sometimes, as things develop, the other groups weren’t even aware of these system developments,” she said. “Access and handover of care become a challenge. Healthcare practitioners don’t understand the complexity of the various systems, resulting in complex workflows and duplicated data in multiple systems. “There’s also fragmentation of patient information, which becomes a safety concern.” [Read more: Monash Health and SCHS commence EMR rollouts | SA Health upgrades its EMR system following review] As such, Burke suggested that EMR implementations should be done in accordance of the needs of an organisation and include: A system that speaks the same language, and have the same character-field limits  A secure, integrated system that works across the entire organisation  Staff training across the entire organisation  “What we need to do is create seamless continuity of care across the organisation; enable systems for patient safety, quality and outcomes; and have systems where we can extract data from so that we end up with better analytics, better research and better outcomes for our patients,” she said.

Top takeaways from a month of reporting on today's current state and the future of health data sharing.

The physical therapy space went from 15 percent EHR adoption rate to 85 percent, says Shawn McKee, VP of marketing at WebPT.

Dartmouth-Hitchcock is able to customize best practice processes from the technology out of the box – helping manage Epic's many environments, constant requests and complicated infrastructure, one IT exec explains.

InterSystems has included a unified provider directory as part of its HealthShare suite of connected health solutions, aiming to drive collaboration and innovation across the care continuum. HealthShare brings together health providers, patients and payers with a unified care record and the newest member of the suite, HealthShare Provider Directory – available as part of HealthShare 2019.1 – is a single source of information for provider demographic and professional relationship information. Specifically, it is a master data management solution that automates the process of collecting, consolidating and publishing accurate provider information. The latest HealthShare release also includes enhancements to its clinical viewer, expanded HL7 FHIR capabilities and out-of-the-box analytics functionality. The move follows recent news that InterSystems launched a new TrakCare clinical system that allows healthcare professionals to use touchscreen devices to create patient notes with swipes and taps, capture images and barcodes via camera, and add information by voice. According to the company, the upgrades to HealthShare enable users to more easily comply with regulations, enhance customer service and improve the efficiency of any business process that requires up-to-date and accurate provider information. InterSystems HealthShare Vice-President Don Woodlock said the latest version of HealthShare offers more functionality, scalability, communication and extended decision support. Woodlock added that inaccurate provider information has consequences for patients, payers and providers themselves as wrong telephone numbers and location information limits access to care. [Read more: InterSystems launches recruitment drive for its pioneering NT digital health system roll out | InterSystems lands $259 million Northern Territory healthcare IT project] In addition, he said inaccurate information propagated across multiple clinical and administrative systems at a hospital or integrated delivery network can negatively impact efficiency and cash flow. “Interoperability and information exchange are hot topics now, but technology can do better than simply moving data around,” he said. “If government initiatives are going to be the foundation for innovation in healthcare, organisations need to aggregate information and build upon a true unified care record – then put the data to use to improve patient care experience, drive down costs and improve the health of populations.” In addition, as part of the updated release, InterSystems has also renamed its flagship HealthShare product module, HealthShare Information Exchange, to HealthShare Unified Care Record.

As health systems merge, the need to reconcile data sets from disparate EHR systems for population health and quality improvement is critical, and artificial intelligence can help, the company says.