Healthcare is a knowledge industry, and information is one of its core commodities and one of its enablers. The purpose of an electronic health record (EHR) system is twofold. First, EHRs place accurate and complete information in the hands of clinicians when and where they can best support quality patient care. Second, they enable meaningful sharing and use of health information throughout the healthcare system. Systems that meet these objectives offer better outcomes for patients, populations and the healthcare system as a whole.
Keys to a successful EHR
Accenture, in 2015, said the global EHR market is expected to exceed US$22 billion, largely as a result of government
incentives and mandates. This expenditure of public funds is an investment in systems which, in many countries, is expected to improve quality, safety and efficiency of their healthcare systems, and help stem a tide of rising costs instigated by the demands of aging populations, increased prevalence of chronic diseases, rising consumer expectations and advances in the life sciences.
Beyond initial reductions in record keeping and storage costs, benefits from EHR implementation will most likely realized in proportion to an EHR’s ability to share and use clinical information to enable or enhance patient, population or health system outcomes. To help support adoption and effective use of clinical information systems, HIMSS Analytics and Gartner have produced well-established assessment tools which identify key features and capabilities of clinical systems at different levels of maturity and use. Both identify structured data and controlled medical vocabularies, such as SNOMED CT, and described on its page. It’s an essential EHR feature needed for advanced interoperability to enable widespread sharing and use of clinical information.
Data that makes sense
Simply put, computers, like people, can process and act on information better when its presented in a familiar format using familiar language. Formally structured information and controlled vocabularies, like SNOMED CT, enable EHRs to recognize important information in patient EHRs and to use it to support healthcare decision making, care delivery, monitoring, reporting and analysis.
Some clinical information systems use integrated terminology products to help automate administrative coding, capture processes, and employ standards-based data exchange to link local systems to government-hosted knowledge resources. These interconnected solutions are important because stakeholders throughout the healthcare community have interdependent and shared information needs. For example:
- Healthcare providers, regulators, public and private sector payers and researchers all use information gathered at points of care to provide services that help make healthcare accessible, safe and effective for patients
- Healthcare providers aware of innovations, regulatory requirements and patients’ healthcare coverage are better at personalized healthcare that includes developing care plans aligned with best practice and tuned to patient needs and ensuring patient compliance and patient outcomes.
A combination of different standards in a healthcare system provides a clinically validated way for computer systems to collect, connect, aggregate, translate and exchange health information for various uses. An EHR without standardized, structured data is just a computer with only a paper record functionality.
Information systems that can recognize patterns in health information and deliver current and actionable information to healthcare providers that’s relevant to their work, can help users stay abreast of innovations, recognize patients’ needs and deliver better outcomes for their patients.
Long term investment
From an economic perspective, health information has potential to deliver economic and socio-economic returns to organizations. Return to organizations as cost savings accrue from uses that improve patient outcomes or provide more effective and efficient use of technology and pharmaceuticals. Socio-economic returns include benefits to patients, carers, communities, healthcare providers, payers, population health management and researchers. Many of these accrue from better informed patients, safer healthcare, more streamlined healthcare, better productivity and less waste Several studies show that the cost for standards implementation is minor in relations to the return in a longer perspective.
Health information in unstructured narrative form is difficult and expensive to exchange and reuse. An example is the significant time lag between knowledge discovery and its translation into everyday practice. Consistently, encoding information in EHRs, clinical criteria within decision support tools, and abstracts of knowledge resources using SNOMED CT, helps make health information more discoverable, more exchangeable, and more interoperable, and more reusable across organizations. The benefit is more efficient and effective healthcare services as information is shared, leading to improved patient and population health, better and more appropriate use of technology, improved health system financial outcomes and societal benefits that accrue from a healthy populations and more efficient and effective use of healthcare resources.
The big challenge is that decisions are needed on which standards to use to enable optimal interoperability. It’s compounded when vendors use different ones that suit their product best. The “e” in eHealth or the “IT” in health IT can help to achieve better health as long as it reflects all aspects, such as people, organization, standards for technical and semantic interoperability, and not to leave out the patients and their carers.