"The industry needs to think about how EHR technology most effectively leverages data to the patient's benefit," says Amanda Hansen of AdvancedMD. "There's still work to be done."
Amanda Hansen's father had diabetes for most of his life, until his death in March 2017. Like many patients, he had to collect his own medical records and carry a thick stack of paper from provider to provider to control his own healthcare journey.
Seeing the continuous problems he had managing his condition on a paper system drove in Hansen a passion for health IT. She now is president of AdvancedMD EMR, a vendor of medical office software.
The case for electronic health record systems is obvious, but there can be problems with implementation, data interoperability and the overall clerical burden for providers.
Hansen believes health IT vendors have a responsibility to help providers close the loop with patients – especially those with chronic conditions – ensuring providers are ordering the right labs and prescriptions and patients feel engaged and have the right questions to ask.
Hansen says she wants to fix EHRs, which is why Healthcare IT News sat down with her to discuss her thoughts on fixes, her father's experience and technologies that can best help with chronic conditions.
Q. Your father's healthcare experiences had a major impact on you. Please talk about his experiences and how they affected you.
A. Since my dad was a toddler, much of his life was about managing his Type-1 diabetes. As he aged into his 40s and 50s, it was a big part of both my life and my mom's life, too. He saw numerous specialists, underwent transplants, sat through thousands of hours of dialysis, and experienced vision loss. We lost him at just 60 years old.
While I remember so many wonderful things about my father, now, as a leader in health IT, I think back to his medical experience and lament the limitations of healthcare provision during this era.
Unfortunately, management of his chronic condition pre-dated electronic health records, and paper records brought a lot of baggage – literally. My mother and I carried big binders with us to his appointments, filled with papers that detailed his complex medical history.
Each specialist, doctor and surgeon would page through this past, holding the actual weight of our sadness and trauma.
They'd always have more questions, just trying to piece together the facts of the case like historians. I imagine how much simpler and more streamlined our collective experience would have been if my dad had an electronic file with digital records.
As healthcare technologies have evolved, I am relieved that patients no longer have to carry binders and face the many obstacles that paper charts created. For every solution we develop, for every interoperability problem we solve, we are making healthcare seamless for both providers and patients.
Episodes of care and chronic disease management tasks can be daunting. They shouldn't be. We are committed to transforming healthcare so the experience is seamless, unified and complete.
Q. You believe health IT vendors have a responsibility to help providers "close the loop" with patients. Please elaborate.
A. While we've left those binder burdens of paper behind in favor of digitization, there's still more health IT vendors must do to ensure a closed-loop experience. Especially for chronic care and complex patients, it's critical that workflow processes help prevent comprehensive care gaps, which put patients at risk of adverse outcomes.
It's also vital that lab and pharmacy functions are well integrated into patient management tools so those elements are included for comprehensive, coordinated and efficient care management.
Today's successful EHRs support providers and engage patients to facilitate reaching the right patient at the right time with the right treatment. True interoperability among key systems and providers helps clinicians guide chronic care patients with minimal time and effort.
Automation is a big part of this. We leverage automated tools so providers can spend more time nurturing meaningful relationships with patients.
These relationships, while always built on a foundation of human interaction, are strengthened by patients' engagement in their own care. By keeping in touch with patients often and via their method of choice – text, call, email or portal, for example – communication and task execution happens on their terms.
By offering online messaging, appointment scheduling and reminders, bill pay, medical records and results retrieval, pre-arrival preparations for more streamlined check-in, and similar functions, providers encourage patients to be engaged, adherent and proactive.
Guided by the right technology, chronic care management is a true team effort. As health IT vendors, facilitating this engagement is our responsibility.
Q. You've said you want to fix EHRs. What's wrong with them, and what do you see as the solution?
A. As anyone in healthcare can attest, EHRs have benefits and drawbacks. In general, problems are solvable and are far outweighed by the advantages of EHRs. What we've seen with the technology is that some solutions are "cookie cutter" and cannot accommodate practices' unique workflows, patient populations or overall styles.
There are so many moving parts as well as existing billing and practice management systems in place that many EHRs – as they are designed – fail to facilitate seamless functionality. They also are unable to provide a holistic picture of the entire patient experience.
For an optimized EHR, it really must provide clinicians with an immediate and quick sense of the patient's comprehensive medical history. When administrative overhead is kept to a minimum, clinicians can solely dedicate their time and effort to providing high-quality care to their patients.
Efficiency in the provision of care – particularly as the industry moves toward value-based care – requires a customized, scalable technology, and some EHRs simply don't fit the bill.
Health IT vendors are maximizing their impact in the development of technologies that enable tailored and meaningful patient interactions. EHRs not only provide the individual patient view, but they're also able to leverage larger sums of data about treatment plans that help providers decide about optimal care paths for better outcomes.
The industry needs to think about how EHR technology most effectively leverages data to the patient's benefit. There's still work to be done. Digitization and integration will make it feasible.
Q. Chronic conditions are of particular concern to you. What technologies can help providers best deal with chronic conditions?
A. As I saw with my dad, management of chronic conditions can be very complex and taxing for patients, their families and providers. It's also very expensive.
The CDC reports that 90% of annual healthcare expenditures, totaling $3.8 trillion in the U.S., are for people with chronic and mental health conditions. And poor patient management contributes to this cost: When conditions aren't appropriately managed in a timely manner, larger, more costly problems surface later.
For providers striving to provide excellent care in this tightening reimbursement climate, efficiency is key. Many offices are struggling to manage clerical and administrative burdens in complex condition management, and burnout is currently high.
EHR technologies that unify seamlessly with practice management and patient engagement tools allow clinicians to deliver high-quality care consistently. When technologies are leveraged to encourage and maintain patient involvement in their own care, it's evident in their outcomes as patients progress toward treatment goals, particularly when related to lifestyle changes and medication management.
Health IT leaders must continue to invest in technologies that guide effective chronic disease management. While today's chronic care patients are better off than those in decades past, engaged patients of the future will reap further benefits of smarter, well-integrated technologies.
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