What will the next generation of EHRs look like? 5 CIOs weigh in

The first generation of electronic health records first appeared in the 1960s and focused on meeting the administrative needs of clinicians, but as the healthcare landscape continues to evolve, hospital and health system CIOs want EHRs to generate a more holistic view of a patient, as well as integrate AI and machine learning capabilities to improve patient outcomes. 

Simplifying the user experience

"The next EHR should focus on simplifying the end-user experience by reducing screen clutter and click counts," said John Cross, CIO of Douglas, Ga.-based Coffee Regional Medical Center.

Mr. Cross said one way this could work is by implementing healthcare AI-based large language models into EHRs instead of preprogrammed decision trees.

"That would have the potential to simplify the end-user experience and enhance care quality," according to Mr. Cross.

A​​ccording to research from the University of Missouri in Columbia, EHR systems aren't living up to their potential. And as more physicians report higher levels of burnout, EHR tasks are being largely attributed to administrative burden as physicians report losing clinical hours to them. 

"The EHR should make the lives of our clinicians easier, not harder," Darrell Bodnar, CIO of Whitefield, N.H.-based North Country HealthCare told Becker's

Mr. Bodnar said he hopes to see EHR systems aid clinicians to once again focus on the delivery of care, not spending their time in front of a screen.  

"We have shifted so much of the care delivery process onto the shoulders of our clinician over the past 25 years, I would really like to see the pendulum swing the other way and have the technology start to make their lives easier," Mr. Bodnar said. 

In a study published Jan. 22 in the National Library of Medicine, EHR documentation tasks, design, workload and inbox alerts were found to contribute to physician burnout. 

This burnout leads to low-quality care, behavioral issues, mental health complications, substance abuse, career dissatisfaction, higher turnover rates, and a decline in patient safety and satisfaction, according to the study. 

Can ChatGPT integrations move the needle for future EHRs?

"Future EHRs should have artificial intelligence capabilities to improve patient outcomes, increase efficiencies, streamline workflows, reduce cost and address provider burnout by not being too click heavy," Sunil Dadlani, CIO of Morristown, N.J.-based Atlantic Health System told Becker's

Mr. Dadlani said if EHR systems leverage machine learning, generative AI, natural language processing, virtual reality blockchain and advanced predictive analytics capabilities, this could significantly help hospitals and health systems support more personalized care.

Mr. Bodnar also said he believes advanced technologies like AI and ML will be built into future EHR systems. 

"Ambient voice recognition will be the source of data input and in most cases because of its advanced capabilities and a future iteration of ChatGPT, it will be quick to post with minimal editing by the clinician," Mr. Bodnar said. 

Epic Systems, the EHR vendor that controls nearly a third of the U.S. hospital market share, recently said it will be using GPT-4, an AI-powered tool built by OpenAI, to help physicians and nurses spend less time at the keyboard and to help them investigate data in a conversational way.

Making interfacing with emerging technologies more efficient 

"The next generation of EHRs should focus more on the holistic patient journey and experience, as well as interfacing with third-party and custom innovative and emerging technologies," Brad Reimer, CIO at Sioux Falls, S.D.-based Sanford Health told Becker's

Mr. Reimer said he hopes to see EHRs open up their platforms so that various interfaces such as data, APIs and workflow integrations can be more simple. 

"There is an enormous amount of money being poured into healthcare tech innovation outside the traditional EHR companies. Being able to stitch together a variety of innovative solutions into a seamless and consistent patient experience is critical," Mr. Reimer said.

He said EHRs provide great value and opportunity for patients, but if they can't open up their platforms to emerging technology, they will remain technical silos.

More quality data exchanges

According to the ONC, 96 percent of all non-federal acute care hospitals and nearly 4 in 5 office-based physicians have implemented a certified EHR system, but barriers remain around creating a uniform nationwide network interoperability across care continuums. 

"Right now, we can exchange information, but most of it is not in the form and timing that the providers need," Linda Stevenson, CIO of Norwalk, Ohio-based Fisher-Titus Medical Center told Becker's

Ms. Stevenson said going forward, she would like to see EHRs have more standardization in their ability to exchange quality information for continuity of care. 

According to a survey from healthcare data company Intelligent Medical Objects, 90 percent of provider leaders, who are responsible for implementing and purchasing technology at their healthcare organizations, said they lost revenue due to inefficient data usage. 

But, with the promise of AI and machine learning integrations, Mr. Bodnar said data will have the opportunity to be filtered, condensed and summarized to provide data, in a timely manner, to clinicians. 

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