Electronic Health Reporter

Guest post by John Squire, president and chief operating officer, Amazing Charts/Pri-Med.

As president and COO of a leading electronic health record (EHR) and practice management (PM) provider, part of my job is to be in constant communication with providers about health IT.  They tell me and my team what works for them and what doesn’t work; what brings joy to their practice and what keeps them up at night. All this insight helps polish my crystal ball, making it clear what we can expect to see in 2016:

EHR system will pivot from regulatory compliance to physician productivity. EHRs are generally blamed for fueling the professional dissatisfaction of physician. A few software vendors are looking at the problem-oriented medical record (POMR), a more intuitive approach that works similarly to the way a doctor thinks. It organizes clinical records and practice workflows around specific patient problems, making it faster and more satisfying for physicians to use.

The problem list not only delivers a “table of contents” to clinically relevant issues, but also gives a provider a longitudinal view of a patient’s healthcare over time. This intuitive method of information organization makes it easier for provider and patient to set the agenda at the start of the exam. During the exam, the POMR supports the nonlinear nature of a patient encounter.

The POMR also helps reduce cognitive overload, which can lead to medical mistakes such as misdiagnosis and other potentially life-threatening errors. Providers can see “bits” of data like lab results associated with a specific problem, thus easing the number of mental connections required to make sound medical decisions.

Chronic care management (CCM) will grow quickly because it makes sense for both patients and providers. Our healthcare system is changing to address the needs of an aging population with chronic illnesses like hypertension, diabetes, heart disease, and more. To promote the effective care coordination and management of patients with multiple chronic illnesses, the Centers for Medicare and Medicaid Services (CMS) introduced CPT code 99490. This code reimburses providers for remote, inter-visit outreach, such as telephone conversations, medication reconciliation, and coordination among caregivers.

The reimbursement for CCM services is an average of $42 per month for Medicare beneficiaries. New levels of technology integration will enable clinicians to complete CCM reporting of remote care from inside their EHR system.

Healthcare costs will get more transparent. The Affordable Care Act (ACA) encouraged millions of people to sign up for high-deductible plans, which means routine healthcare is paid for out of pocket. As a result, many of these patients are demanding more price transparency from their physicians and insurers.

Non-traditional value-based payment models—such as Medicare Advantage, Direct Primary Care (DPC), and on-jobsite clinics—will continue to grow in popularity as more people seek alternatives for primary care. Providers are drawn to these new models because they can eliminate the overhead of the traditional third-party payer system, see fewer patients per day, and spend more time with each patient

EHR interoperability will remain elusive. CMS will continue to promote the idea of standard interfaces between disparate EHR systems to enable information exchange among physicians, hospitals, health information exchanges (HIEs), and other elements of the broader healthcare ecosystem.

While EHR interoperability exists within the networks of some Accountable Care Organizations (ACOs) and HIEs, outside of these organizations the business case is weak and active participation in sharing data is relatively low. The full potential of interoperability will not be realized until industry places population health and seamless exchange of data ahead of corporate silos.

When these changes do occur, the future EHR will manage them in the background, in a way that maximizes productivity and does not interfere with patient visits. It will support the ability of providers to operate independently, but still interact with their ecosystem.