Becker's Hospital Review

15 Executive Briefing Sponsored by: N early 10 years after the passage of legislation meant to spur health IT adoption, EHRs have undergone a rapid evolution. In 2016, an analysis by the ONC deemed EHR adoption "nearly universal" among acute care hospitals, with 96 percent of facilities live on the technology. A separate study, published in American Journal of Health-System Pharmacy in 2017, found 99.1 percent of hospitals had partially or completely implemented an EHR system in 2016, up from 33.6 percent in 2003. It's safe to say EHR technology has fully permeated the U.S. acute care environment, constituting a win for meaningful use legislation. Whether physicians believe the technology has improved daily workflows and patient care, however, raises a separate issue. As personal technology devices give clinicians increasing mobility in their everyday lives, their potential in streamlining hospital operations and coordinating patient care is clear to clinical stakeholders. As a result, many CIOs are interested in solutions that better suit clinicians' active workflow and help untether staff from desktop computers. Portable and secure endpoint devices — laptops, tablets and smartphones — enable clinicians to access medical charts anytime, anywhere to review patient data. In the shift away from traditional acute care settings, an emphasis on mobility empowers hospitals to address physician satisfaction, accelerate care delivery and improve patient outcomes. Today's EHR landscape leaves room for improvement Adoption of EHRs nationwide is often attributed to the 2009 passage of the Health Information Technology for Economic and Clinical Health Act, a law aimed at promoting meaningful use of IT across the healthcare industry. The legislation succeeded in encouraging hospitals to implement EHR technology, yet challenges remain. Although the majority of hospitals have implemented EHRs in the past decade, many IT systems have struggled to keep pace with the large — and diverse — amount of patient data continuously thrown at healthcare organizations. "As greater importance is placed on care outside the hospital and as mobile technologies enable more advanced care [delivered] at a distance, the patient's data is likely to be sourced from many different environments, devices and care providers," says Wyatt Yelverton, a health solutions manager at technology company Lenovo. "We have lots of data from everywhere — from clinicians, payers, regulators and, increasingly, from the patient," he adds. "The reality, though, is we're still learning how to manage so much information." Mr. Yelverton says the rapid expansion of patient data has intrinsically shifted how physicians use EHR systems. "The proliferation of connected devices and expectations around interoperability are fundamentally changing the nature of how information is coming into our clinical systems. … It's also increasing the complexity of our clinical decision-making," he explains. For many hospital leaders, these evolving priorities strain their staff's relationship with technology. "In many instances, providers have found the EHRs they've adopted simply can't meet their needs," Mr. Yelverton says. "That pressure often leads to a decision to replace their legacy systems." Rather than replacing legacy systems — which can cost organizations hundreds of millions of dollars — Mr. Yelverton offers hospital leaders a more cost-effective alternative: complement existing EHR investments with mobile endpoint devices, such as laptops, tablets and smartphones, that connect clinicians to patient data with increased flexibility. With more options for endpoints, a physician has 24/7 connectivity to relevant patient charts from within his or her pocket. How to bring physicians 'anywhere connectivity' A major demand from today's physicians is what Mr. Yelverton refers to as "anywhere connectivity," or a clinician's ability to access relevant patients' data regardless of his or her location. In the consumer space, physicians have experienced the "miniaturization" of technology — and they're now bringing these expectations with them to the medical world. "The common everyday endpoint devices are becoming much more mobile-centric," Mr. Yelverton says. "We think about laptops becoming very, very thin and light, and what that means for physicians moving through different health environments." This emerging focus on limitless connectivity hints at two interrelated health IT concerns: mobility and interoperability. Clinical mobility refers to a physician's use of mobile devices to access patient data. For example, a physician might access a patient's EHR from a tablet at the bedside or view remote monitoring data of a post-operative patient through a smartphone, rather than only being able to access these systems on a desktop monitor. However, not all EHR systems offer associated apps or cloud connectivity. Are smartphones and tablets the next frontier for EHRs? Why this IT expert says yes

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