Who's the real customer for EHR systems. Is it the healthcare provider or is it the patient? How EHR vendors answer this will determine their future. https://t.co/1wPadMTXlZ
— Clay Forsberg (@clayforsberg) August 2, 2018
What a fascinating question from Clay Forsberg. In my experience writing about the EHR space, the EHR customer is the healthcare provider and not the patient. In fact, I think the impact on patients played a very small role in most EHR implementations. I don’t remember ever seeing an EHR RFP that had much of any focus on the patient. The closest you might come is that the EHR would need to have a patient portal or something along those lines. Have you seen patient focused sections of EHR RFPs? If so, I’d love to see them. If not, I’d love to see it too.
When EHR software was first being purchased (technically it was EMR at the time), the decision was largely around how they could better handle things like E/M coding and being able to use the automation in the EHR to be able to bill for higher levels of care (ie. more money). This is what’s led us to EHR note bloat.
Following this EHR era was what I call the golden age of EHR adoption fueled by $36 billion of meaningful use money. I was shocked at how irrational the market became as doctors chased EHR software that would get them access to the meaningful use dollars and avoid any penalties. There was no time for doctors that purchased EHR software in this era to really think about patients. They were too focused on the government handouts.
Long story short, the patient has generally been far from the thoughts of those purchasing EHR software. Don’t get me wrong. I don’t think most people purchasing EHR wanted to recklessly damage the patient. In fact, EHR benefits the patients in a lot of ways (access to the records is one example). However, it’s not any stretch to say that those selecting and implementing EHR software weren’t trying to improve the patient experience. If it was, they would have made different choices.
The question is will this change in the future. Or maybe even more importantly is will EHR vendors be able to evolve in a way that patients will benefit. I think we will see some evolution in this regard, but I don’t expect to see a sea change when it comes to EHR software’s focus on the patient. I think instead we’ll see 3rd party software that will change the patient experience. Some of them will integrate with EHR software which is why EHR APIs are so important, but I’m not looking for the EHR to make the patient their customer. Maybe they should, but I don’t see it happening.