Becker's Hospital Review

43 CIO / HEALTH IT The next evolution of EHRs: What to expect in 2021 and beyond By Laura Dyrda E HRs have become an integral part of the healthcare delivery system in the past decade and will continue to evolve in the coming years to alleviate the tech bur- den on healthcare providers and add to the clinical decision-making process. Nearly all large healthcare organizations, and many smaller ones as well, have implement- ed EHRs to gather and report data. What will the next iteration look like? Becker's asked the four largest EHR compa- nies — Epic, Cerner, Allscripts and Meditech — what to expect from their technology in the future. Here are six big takeaways: 1. Natural language processing and voice as- sistants will make it easier for clinicians to connect with patients. Clinicians can now use their voice to search a patient's medi- cal history and place orders within the Epic EHR. "In the future, the voice assistant will also be able to write the clinician's note and close the visit. We demonstrated a 'click- and keystroke-free' office visit at our Users' Group Meeting last August," said Sean Bina, vice president of patient experience at Epic. "We'll also increasingly use data to drive evi- dence-based medicine." 2. e EHR design and accessibility will help save time per patient and increase documen- tation accuracy, according to Paul Black, CEO of Allscripts. "e trends emerging from our research show the desire for a fully connected, mobile EHR, where information is presented in context that is purpose-built for the device — a watch, a tablet, a phone or on the web. In addition, it is able to in- herit and leverage the benefits of the device, including location, gestures, messaging and voice," said Mr. Black. 3. e next generation of EHRs will also focus on data liquidity to make patient and consumer data more accessible, portable and consumable regardless of where it originates, especially with the federal government's fo- cus on interoperability. "With Cerner tech- nology advancements and focus on what data can do for healthcare, we are enhancing the ability to access and exchange data between our clients and any organization," said Will Mintz, Cerner's chief strategy officer. "Cerner is taking interoperability beyond connectivi- ty to true usability by creating a single, longi- tudinal record that ultimately is useful in any care venue." 4. EHRs will further embrace apps and technologies across the healthcare indus- try, according to Meditech's executive vice president, Helen Waters. "We need to ease the burden on patients and clinicians, melding natively into their natural work- flows by using web and mobile technolo- gies that offer the same convenience and conventions as everyday smartphone and touchscreen devices," she said. "We also need to offer advanced decision support to adjust to rising patient volumes." 5. Telemedicine has become increasingly im- portant during the pandemic. Patients and clinicians can now launch virtual care visits directly through the EHR and the function- ality will be an important aspect of future electronic medical record iterations. 6. e large EHR companies are working with big tech to advance cloud-based initia- tives. Epic's cognitive computing platform allows systems to place data in the Microso Azure Cloud for heavier processing and then feeds insights back into the local Epic work- flow. Allscripts also has a partnership with Microso, which is the cloud provider for its Sunrise EHR. "Our partnership with Microso has been recognized for giving us an advantage over the competition in innovation and shiing to the cloud," said Mr. Black. "Microso invest- ments in cybersecurity are tremendous, their focus in the healthcare segment is significant, and they are already exploring new horizons, including digital twins and advanced artifi- cial intelligence with us." Cerner has a partnership with Amazon Web Services, which worked to rapidly deploy the Cerner Command Center dashboard to cli- ents in the cloud. n MD Anderson avoids $4.3M HIPAA fine By Jackie Drees T he U.S. Court of Appeals on Jan. 14 vacated University of Texas MD Anderson Cancer Center's $4.3 million HIPAA fine for losing more than 35,000 patients' protected health information. The court ruled that HHS had acted arbitrarily and inconsistently in finding that the Houston-based cancer center had violated two information security regulations stemming from three data breach incidents in 2012-13, according to the U.S. Court of Appeals for the Fifth Circuit opinion filed Jan. 14. In June 2018, HHS fined MD Anderson $4.3 million after completing its inves- tigation of the theft of an unencrypted laptop from the cancer center and loss of two unencrypted flash drives. HHS found that while MD Anderson had en- cryption policies since 2006, it did not adopt systemwide encryption of elec- tronic PHI until 2011. HHS' Office for Civil Rights said the cancer center also failed to encrypt its inventory of electronic devices containing ePHI between March 24, 2011, and Jan. 25, 2013. MD Anderson appealed the HHS fine in April 2019, arguing that since HHS is a federal agency it did not have the authority to impose civil monetary pen- alties against the cancer center since MD Anderson is a state agency. The hospital also argued that HHS's penalty was excessive. After MD Anderson filed its petition with the Court of Appeals, HHS conced- ed it could not defend a fine for the breaches of more than $450,000. The court vacated the civil monetary penalties and remanded the case for further proceedings consistent with the opinion. n

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