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May 29, 2015 12:00 AM

Healthcare computer experts tackle EHR shortcomings

Joseph Conn
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    A prominent professional association of healthcare computer experts has come up with a set of recommendations to address challenges clinicians face as they're expected to do more with electronic health records systems.

    The 11-page “Report of the AMIA EHR 2020 Task Force on the Status and Future Direction of EHRs” looks at five current problem areas and offers 10 recommendations to address them.

    The report was prepared by an all-star panel of 14 informaticists, most but not all of them physicians, working in care delivery, government, academia and software development. The panel was headed by Dr. Thomas Payne, medical director of information technology services at the University of Washington Medicine.

    The report seeks to address some of the more serious “unintended clinical consequences” of broad adoption of EHRs, catalyzed in large part by the $30 billion federal EHR incentive payment program under the American Recovery and Reinvestment Act. These include “reduced time for patient-clinician interaction” and the transference to front-line clinicians of “new and burdensome data-entry tasks.”

    One problem area identified by the group is the need to simplify and speed up documentation, which is performed by physicians on electronic systems to a greater degree than it was on paper.

    Another issue addressed by the group is government regulation of the industry, particularly providers, with a call to “refocus regulation” with an eye toward improving interoperability and prioritizing patient outcomes over demonstrating new measures of EHR functionality.

    The group also wants an overhaul of the federal government's EHR testing and certification program to make it more flexible and transparent.

    The AMIA panel joined a growing chorus of informaticists and IT developers endorsing the development of application programming interfaces, or APIs, bits of software code that could promote easier access to EHR data by mobile health applications to “foster innovation.”

    And the group wants to also open up access to electronic medical records for use in a broadening spectrum of care-delivery venues and strategies, from patient-centered medical homes to pharmacogenomics.

    “Much of the focus of the last decade, via (the EHR incentive payment program) and other incentives, was to encourage providers and other health professionals to implement EHRs and use them to capture and share data important to quality and cost,” the report said. “The work now ahead is to ensure that these systems are designed and implemented in a way that yields promised benefits to efficiency, quality and safety with fewer side effects."

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