Depending on who you ask, electronic health records (EHRs) are a blessing, a curse, or both. While moving to digital medical records has undoubtedly saved countless lives and improved healthcare overall, many providers struggle with them, either from a lack of vendor responsiveness, an inability to communicate with other providers, or not enough information to evaluate the quality of the EHR systems themselves.
Certainly, no one is suggesting we go back to a time before keeping electronic records, when patient information was recorded on paper, coordinating with providers required phone calls and fax machines, and illegible handwriting could result in avoidable medical errors. But today, EHRs have presented different kinds of usability and patient safety issues. Improving the transparency of EHRs is critical if we want to continue to improve healthcare in our communities.
Fortunately, in the next month we have an opportunity to help make some improvements a reality. There are changes afoot and programs underway that will allow providers to communicate more freely and address usability and safety issues and facilitate better choices, but we need healthcare experts and other stakeholders to actively play a role in the process.
The Office of the National Coordinator (ONC), a part of the federal Department of Health and Human Services (HHS), has proposed extensive new rules to implement the 21st Century Cures Act. Some of the specific provisions will allow providers to share both the positive usability and patient safety advances as well as negative components that may contribute to medical mistakes or poor health outcomes. This change would prompt swift action to address and fix problems, especially as they relate to patient safety, and ensure providers have important information necessary to select the best EHRs.
These provisions in the 21st Century Cures Act include the following requirements related to certified EHRs:
- Removing the ability of EHRs to include “gag clauses” in their contracts that limit provider communication on critical issues;
- Allowing providers to share screen shots more freely, without infringing on EHR vendors’ intellectual property rights, to better communicate on critical issues, and;
- Easing transitions when providers choose to switch EHRs by requiring more robust data exports to be made available from their current EHR system to a new one.
The Cures Act also required the creation of a new EHR Reporting program to help evaluate EHRs. ONC recently engaged the Urban Institute and HealthTech Solutions to begin work that will ultimately result in a free online resource that allows providers to describe and rate EHR functionality, and compare capabilities across categories including security, usability and user-centered design, interoperability, conformance to Certification testing, and more. Regional meetings will be held throughout the country to get important input and feedback a broad cross section from the healthcare community.
So what can the healthcare community do to help make these changes happen? There are many opportunities for all of us to improve healthcare in our communities and increase EHR transparency.
First, stakeholders should read and weigh-in on the proposed rules—especially as the comment deadline has been extended to June 3. Second, consider participating in the regional meetings for the EHR reporting program to help design the best comparison tool to support well-informed EHR choices. As our healthcare system evolves, we should all be optimistic that these proposed changes and new tools will continue to improve healthcare in our communities.
Valerie Grey is the Executive Director for the New York eHealth Collaborative, a non-profit organization working to improve healthcare by integrating health information exchange (HIE) across the state.
