Electronic health recordsInformation and the digitization of paper records and processes are both fundamental for digital transformation. No digital transformation without digitization and holistic information management approach. In healthcare this is even more true as it is essential that accurate information is available when and where it matters. This availability and accessibility of accurate data and information can make huge differences, not in the least where patients and treatments are concerned.

It’s one of the drivers of the rise of EMR and EHR (systems) since several years now: accurate patient data to make healthcare better. The need to use digital data and digitized information in healthcare today (using EHRs or Electronic Health Records) is not just about getting paper – and the many challenges it comes with – out of the way. It’s not just about speeding up processes or digitization (and its benefits) as such either. These are, albeit crucial, intermediary goals that lead to a higher healthcare purpose.

The goal of digitization in healthcare is improving health and healthcare

It is about selecting, capturing, connecting and managing the right data for the right reasons. It is about having (access to) correct and relevant information which can be used in a valuable and useful way to improve health of individuals and healthcare quality overall, while taking the realities of healthcare workers and other stakeholders into account.

It is part of that ongoing transformation of healthcare as a whole and therefore needs to start with clear definitions of purpose, practical scenarios, roadmaps and the – sometimes conflicting – needs and priorities of all stakeholders which should be involved. In other words: it is part of healthcare as an evolving human and societal system as such, along with information-driven and digital/technological evolutions in areas such as mobile healthcare, telehealth, new healthcare ecosystem business models and of course new possibilities to improve health overall.

Last but not least and as we tend to forget sometimes, it’s part of a more encompassing goal to make healthcare more accessible and efficient for everyone – in the first place the patient and his health.

EHR and EMR: the difference
The electronic medical record or EMR is a digital alternative for the good old paper chart while the more often used and broader electronical health record or EHR is the digital health “file” which is “attached” to the patient’s overall health history and is to be connected across the healthcare ecosystem whereas an EMR traditionally was more meant for an individual healthcare facility or clinician.

Healthcare is about information management – and patient-centricity

At a seminar end 2009 on telemedicine and eHealth, organized by the Leuven Medical Technology Centre in Belgium, Erwin Bellon (back then IT manager multimedia & telematics at the University Hospitals Leuven) mentioned the crucial role of information management in healthcare when saying “most of the healthcare actors are primarily busy generating, processing, transforming and combing information”. Information is the most valuable asset he reminded (PDF opens). It always has been and is even more so today.

Obviously this doesn’t mean that healthcare actors and certainly workers don’t have very patient centered tasks to fulfil going beyond information. The human and emotional dimension is extremely important in the complex reality of healthcare. Yet, getting information flows and data/records right is an ongoing priority.

The case and challenges of EHR today

Within the scope of digitization and information in healthcare, the evolutions towards a more patient-centric approach have gone hand in hand with the advent of eHealth and digital healthcare with the mentioned key role of EMR and EHR. Across the globe, Electronic Health Record and Electronic Medical Record projects have been conducted on various levels, at different speeds and in very diverse ways, among others due to local regulations, healthcare organization systems and other factors.

While in some countries EHR and EMR have found high adoption, in practice there are still many challenges and hurdles. Some of them are related to usage or interoperability, others to culture and wrong priorities before/during implementation and then there is the always human element.

The move towards digital healthcare, here EMR and EHR, obviously isn’t just caused by patient-centric evolutions, which in turn are caused by evolving patient expectations. The picture is far more complex and includes regulatory demands, cost and efficiency optimization needs, the reduction of medical errors, healthcare worker priorities, storage costs of patient files, changing healthcare challenges (think about ageing populations and workforces, for instance) and the economics of healthcare overall, to name just a few.

Most of the healthcare actors are primarily busy generating, processing, transforming and combing information

 

Challenges to address

As said, there is no optimization for an increasingly digital world and customer nor possibility to digitally transform without the digitization of paper and processes. The paperless message is loud and clear in healthcare. However, as is the case in many other industries going 100% paperless simply is impossible.

In reality, paper and digital co-exist, although everything what remains paper-based for numerous reasons needs to be digitized and at least archived as well, depending on priorities. As written in a previous blog post, “being paperless” is not a goal as such. Offering the best healthcare (ecosystem and services) is. Getting the paper out of the way, gaining faster access to digital information and the reduction of paperwork are key enablers to make this happen.

From a data capture, paper and information management perspective we see various – interconnected – ongoing evolutions/challenges regarding EHR. Below are a few.

  • There are still many paper-based processes that need to be digitized and optimized with differences per country and per type of healthcare stakeholder. We are far from a paperless overall healthcare.
  • Interoperability and effective use of digitization possibilities remain a challenge. The usage of EMR/EHR and scanning/digitizing paper information is key to succeed, yet many healthcare professionals have an EMR but don’t use it.
  • Some early EMR/EHR projects are being reviewed as they failed to deliver, often because of erroneous strategies and a lack of taking the stakeholders and goals into account (enough). With a move to patient-centricity, some of them also reconsider the ways information gets digitized (e.g. where it happens across various processes such as patient onboarding).
  • For a multitude of reasons (cultural, personal, historical, legal etc.) a lot of paper is still being used and even preferred by some healthcare professionals or simply a must in specific situations. The challenge here is how to combine this reality with the reality of the need to add these paper documents to digital workflows.

There is still a lot of work regarding the actual usage of EHR, as there are still many countries where adoption is lagging behind. But adoption and digitization alone aren’t enough. Without taking the reality in the field and the stakeholder concerns and needs into account, it simply doesn’t work.

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