Becker's ASC Review

21 HEALTHCARE NEWS 21 Have EHRs been good for healthcare? By Giles Bruce F ieen years aer meaningful use incentives propelled the shi to EHRs, health system leaders told Becker's that digitizing medical records has been a net positive for the industry — with some caveats. "Regardless of your position, there is no doubt that EHRs have changed the face of healthcare," said Sandra Hales, associate vice president for IT clinical applications at Phoenix-based Banner Health. "Patients now have timely access to records and data that is simplified for understanding, and there's a level of inclusivity and responsibility for patients to engage in their own care." A challenge is that clinicians commonly feel an electronic screen has come between them and their patients, oen for the purpose of increasing daily documentation for reimbursement, she said. But she called the data generated from EHRs, as well as their algorithms and safety checks, "invaluable." "Lives are saved from simple human error," she said. In 2009, then-President Barack Obama signed into law the Health Information Technology for Economic and Clinical Health Act, aka the HITECH Act, part of a larger economic stimulus package that provided about $35 billion in incentives for hospitals that made "meaningful use" of EHRs. Many health system leaders agreed that the transition to digital wouldn't have happened as quickly, or at all, without this push. "Meaningful use was necessary in EHR adoption and created a better and more digitized process," said Ed McCallister, CIO of Pittsburgh- based UPMC. "Over the past 15 years, we have not connected the dots as quickly to allow for a truly connected patient experience. I am confident that [artificial intelligence] will accelerate what we know as today's health record." Laura Wilt, chief digital officer of Sacramento, Calif.-based Sutter Health, pointed to one such enhancement, a tool in Epic that employs generative AI to dra patient portal messages. e platform is being used by dozens of Sutter Health physicians, saving them time in triaging and responding to patient communications in the EHR. "While there is always room for improvement within our field, EHRs have helped propel medicine and patient care into the modern era," Ms. Wilt said. Michael Pfeffer, MD, CIO of Palo Alto, Calif.-based Stanford Health Care, said it's important to leverage what EHRs do well and improve upon what they don't, including optimizing all the applications that interact with them. EHRs also laid the groundwork for the next evolution of healthcare technology. "Applying responsible AI requires healthcare to be digitized, and now we are seeing such great advances in AI that will certainly allow us to improve EHRs and transform the way we deliver healthcare," Dr. Pfeffer said. Oakland, Calif.-based Kaiser Permanente was an early adopter, setting out to create an ambulatory EHR in 1997. e health system now has the largest private-sector EHR in the country. Completed in 2010, the EHR has streamlined care, reduced duplication and advanced research, said Kaiser Permanente Chief Medical Officer Andrew Bindman, MD. "Our EHR system enables our teams of experts to seamlessly collaborate and coordinate care across departments and specialties and has fueled transformational health research and clinical practices that continue to improve patient outcomes," he said. AdventHealth, a 52-hospital system based in Altamonte Springs, Fla., completed a $660 million Epic rollout in early 2023, giving its medical professionals "timely access to the clinical information they need at every point of care to provide the highest degree of whole-person care possible," said AdventHealth President and CEO Terry Shaw. e single EHR enables providers across nine states to easily exchange patient data — "whether from across town or across the country," he said. "Our clinical teams benefit from having a more complete picture of a patient's history, thereby improving our healthcare delivery." Kelley Curtis, PharmD, chief pharmacy officer of Boise, Idaho-based St. Luke's Health System, helped implement an EHR aer a merger at her organization. She said the benefits have been innumerable: care coordination, information access, staff efficiency and productivity, data analytics and reporting, regulatory compliance, patient engagement and empowerment. "While EHRs have their challenges, particularly in the realms of cost, technical issues, and the initial learning curve, their benefits in terms of improved patient care, enhanced communication, and better data management are substantial," she said. "At this point, the role of EMRs is pretty undeniable: the value that it brings related to making data available at point of care, and allowing us to share records to deliver higher quality of care coordination," said Sophia Saleem, MD, chief medical information officer of New Hyde Park, N.Y.-based Northwell Health. "Really, we couldn't have achieved that without EHR." On the flip side, she said EHRs made everything in healthcare seem like an "emergency," since patients and colleagues can easily send messages at any time, regardless of the acuity of the issue. She said EHRs were also designed for documenting appointments and not the holistic, patient-centered experience that the industry hopes to move toward. She doesn't expect anything to replace EHRs anytime soon, as they do an adequate job of safeguarding data and boosting patient safety in a litigious healthcare industry. But she said the EHR experience could inform healthcare's shi to the next big technology. "One of the things that we missed out on with EMR implementation was really getting the clinical voice in the design of it," she said. "We should not make that mistake when it comes to AI." Dan Roth, MD, chief clinical officer of Livonia, Mich.-based Trinity Health, said the industry is at an "inflection point" with AI, where technology has the potential to reduce clinicians' documentation workloads rather than add to them. "In the next one, three, five years, we'll be able to significantly alleviate that burden using technologies that are coming," he said. Still, he said, EHRs' benefits have been indisputable with medication safety having improved dramatically via barcode medication administration and care gaps being narrowed by electronic data exchange. He said EHRs went through a "hype cycle," from people thinking they would transform healthcare to disillusionment to, now,

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