What the COVID-19 epidemic could mean for electronic health records?
The era of practice management may involve electronic medical records.
COVID-19 pushed us to quickly integrate innovative patient-centered care models, database management, and information sharing. Although digital health records (EHRs) have received mixed reviews, with much public attention focused on their flaws, high-functioning platforms at large organizations responded with the necessary modifications, including real-time epidemiological data and cross-departmental training activities.
This end-user perspective on EHR advances implies that EHRs have the potential to improve patient treatment during an emergency across all subspecialties, facilitating clinical decision-making and enabling rapid, widespread workflow modification.
Although EHRs are lauded for their usefulness in moments of emergency ranging from natural catastrophes to civil wars1, their ability to tolerate the fast change required to support decision-making in a medical crisis has not been tested.
The Health Information Technology for Economic and Clinical Health Act of 2009 aimed to encourage EHRs to improve the quality, safety, and efficiency of health care. COVID-19 is an unparalleled test of the adaptability and usability of EHRs, coming on the heels of the massive growth of EHRs in US health care. It has the potential to disclose both advantages and inadequacies.
The public health problem has prompted rapid EHR innovation to address needs such as sharing data, data processing, COVID-19 care, and care for those who are not visible in traditional settings. For weeks, a diverse group of healthcare and information-technology specialists across our institutions worked to alter our EHRs to serve patient care effectively.
Even though the seriousness of COVID-19 contamination in some individuals brought attention to inpatient care, the crisis significantly impacted outpatient care. Similarly, the EHR hampered ambulatory care’s ability to respond to the crisis.
This article presents an end-user viewpoint on the EHR’s utility during the COVID-19 situation. We can observe how an elevated, shared EHR can accommodate rapid change by looking at a variety of modifications made by centralized health information teams and implemented across disciplines, such as care updates, telemedicine, results in monitoring, patient interactions, and data analysis. We also show how, in some cases, the need for specialty-specific dedication to developing diagnostic devices and therapy modalities to use EHRs may impede such innovation.
The initial EHR modifications that end-users began to notice were connecting COVID-19 testing. With unique entry, release, and testing order sets, developing new order sets for COVID-19 screening proved crucial in both clinical and emergency department (ED) settings. The EHR made it possible to quickly introduce new operations for COVID-19 testing and subsequently handle frequent revisions as the circumstances changed. COVID-19 testing, for example, was once combined with flu testing but was later decoupled when the frequency of influenza in the population declined. Rapid changes in recommendations for which individuals’ examination should be quickly reflected in the EHR.
Mechanisms for the instant launch of COVID-19 testing outcomes to both providers and patients, inclusion of specific diagnostic documents searchable by the chord SARS-CoV-2 to help recognize specific expressions of the COVID-19 disease, and unique in-basket screens for COVID-19 and respiratory examinations to help triage results were among the results locating tools made available to terminate users.
New summary reports with quick-access button designing are happening to aid doctors in interpreting a patient’s COVID-19–related data. Finally, various mechanized and standardized documentation which generates phrases, spanning from COVID-19 screening inquiries in the emergency department to COVID-19 testing material to observations from COVID-19–related contacts.
These were crucial in standardizing paperwork on the front lines in the ED as well as across a number of specialized fields that had to adjust to a new way of providing health care quickly. Care in all situations became safer as a result of widespread access to these findings.
Communication with the patient.
Upgrades to patient interactions were critical in dealing with the influx of messages and phone calls. Templates for patient educational resources, patient-initiated secure messaging, and generation of COVID-19-related visits were done as part of the documentation tools. The EHR facilitated healthcare communication about scheduling in ambulatory care, allowing a major effort including hundreds of thousands of people and assuring that they were not abandoned to obey or delayed in receiving care.
Providers might evaluate patient charts from afar, assess the urgency of postponed patients, and send triage messages to employees.
Patient instructions were quickly written and delivered, with frequent updates and changes on themes ranging from how to utilize telemedicine technology to COVID-19 (signs, symptoms, and prevention) data to new clinic processes meant to protect patient and staff safety.
Data exchange
Clinical professionals and EHR analysts created and deployed systems that enable end-user clinicians to communicate information about COVID-19. Users might quickly evaluate patient data using COVID-19 summary reports instead of entering patient charts. The number of tested patients screened positive for COVID-19, and admitted to the hospital were all presented on enterprise-wide dashboards.
All ambulatory consultations access were centrally prior to the visit, with fast status updates entered into the EHR. CipherHealth, a third-party vendor, handled triage calls. Patients who ended in the failure of the triage screen were notified to all healthcare professionals, inpatient and ambulatory, suggesting further screening before the patient reached the office, lowering the risk of viral exposure.
Make the switch to telemedicine.
COVID-19 permitted a quick move to telemedicine, by aiding the removal of synchronous telehealth regulatory and payment restrictions. Telehealth digital switchboards creation were done to make video visits easier to deliver and to protect patient privacy.
End users have the access to a variety of modifications at first, including outcome monitoring, order sets, documentation techniques (long words, templates), and telehealth platforms and technologies. Doing modifications were to improve the user experience, billing capture and procedure, results, administrative, and research operations integration, and information flow.
Limitations
Despite the EHR system’s comprehensive support, some specializations demanded more than digital portals and communication channels. Furthermore, institutions vary in their ability to utilize the EHR platform for telehealth delivery fully. Penn’s rheumatologist and ear, nose, and throat sections used telehealth systems extensively, with up to 59 percent and 75 percent of all visits completed remotely, respectively.
The effect of EHR development was more limited in other specialties, including them could not be for improvements in compensation or EHR deployment. Even at the peak of the pandemic, telemedicine utilization in ophthalmology was consistently low across institutions, dropping from up to 7% of overall visitation traffic to 1% to 2% as COVID-19 limitations began to ease. Although the EHR can be a vehicle for innovation, specialties like ophthalmology need additional advancement in diagnostic equipment and testing to reap the benefits of remote visits fully.
Conclusions
For a healthcare company, the amount of information readily accessible by EHRs and the capacity to alter them to meet diverse processes can be either a tough hurdle or a huge opportunity. We believe our universities fall into the latter group for COVID-19. We discovered that the EHR architecture is critical to the health system’s survival and the well-being of patients and caregivers.
COVID-19 pushed the healthcare system to adopt new patient-care models, data analysis, and information sharing. We believe that EHRs have the potential to support patient care throughout a catastrophe across all subspecialties, with the ability to enable clinical decision-making and enable rapid, widespread workflow adjustment, depending on this end-user experience. Even though the EHR has the potential to be a vehicle for development, it must be accompanied by specialized diagnostic tool innovation in order for all specialties to benefit from the advancements it supports.
