Today, I was looking at some statistics from the ONC on hospital use of EHRs. You won’t be surprised to hear that as of 2017, more than 95% of hospitals had an EHR in place.
Since vanishingly few technologies are ever deployed by all possible parties, it’s probably fair to call this full adoption, in much the same way that ”full employment” in the US includes maybe four or five percent of adults who aren’t on the job for one reason or another.
What do we do now? It’s a big important question that we’ve barely begun to address. I’d argue that we’re sort of post-adoption but haven’t yet moved into the “full EHR use” era either.
Don’t get me wrong — I’m not suggesting that hospitals are sitting on their hands. In the brief, ONC notes that public policy is now shifting towards the use of EHR data for patient care improvement. And indeed, their statistics show that 94% of hospitals were using this data as of 2017, for reasons that include:
- Supporting quality efforts (82%)
- Monitoring patient safety (81%)
- Measuring organizational performance (77%)
- Identifying high-risk patients (68%)
- Creating individual provider profiles (67%)
- Measuring unit performance (67%)
- Identifying care gaps for patients (60%)
- Assessing adherence to guidelines (59%)
- Developing approaches to querying for data (51%)
The hottest trend among these seems to be the use of data to identify high-risk patients, the use of which grew 15% between 2015 and 2017, followed by identifying care gaps (12% increase), developing approaches to querying data (11% increase) and supporting quality improvement (11% increase).
That being said, however, uptake is lagging for some important functions, such as identifying care gaps. Also, we seem to be far from developing well-defined guidelines or use cases for performing these activities within hospitals. Want to deploy AI or a new flavor of predictive analytics? You may be on your own.
Unfortunately, healthcare leaders don’t have the luxury of spending too much time on data pilots or doing the disruptor thing. If a new approach to data or technology fails in Silicon Valley, companies may go out of business and CEOs might get a public shaming, but usually, no one gets hurt or dies. In healthcare, not so much.
What I’m getting at, I suppose, is that while the new era of data-driven care and operations is upon us, we’re at an era of both crisis and opportunity. (The noted business consultant Homer Simpson calls this “crisitunity”).
My hope is that during this transition, we learn without picking up bad habits that calcify into customs, that best practices reign, that we develop powerful new ways of helping patients. Let the creativity begin!