Standards, Certification, and ePA: Proceed with Caution

By Hans Buitendijk (Oracle Cerner), EHRA Chair

This is part one in a four-part series examining the need for electronic prior authorization (ePA), the barriers presented by the current environment, necessary capabilities and functionality, and the EHR Association’s policy recommendations.

The prior authorization process required by health plans and payers frustrates patients and providers alike because of inconsistent requirements and associated delays, and it isn’t going away. 

It is clear that there is an opportunity to apply health information technology (IT) toward the goal of improving efficiency in this area, but doing so will be a challenge that requires significant cross-stakeholder coordination and standardization of related data. The need for a collaborative focus is further exacerbated by the widely varying approaches to the adoption and deployment of health IT systems among providers. Further, the process itself touches many different points and players in administrative, clinical, and financial workflows. 

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2022 Clinical Workflow Flexibility Challenges in the EHR: Defining the Problem (Part Three)

In our two previous articles, we described an “as-is” exercise with the EHRA workgroup and the HIMSS Physician Committee members where one issue became the focus: the flexibility of workflows. This series of blog posts reviews the results of the exercise and describes a path forward. So far, this series has covered Learning the EHR, Personalizing the EHR and Understanding the Patient. In this article we discuss the fourth and final topic that was raised: Providing Care.

Providing Care
Providing medical care for the patient necessitates “last mile” flexibility that allows clinicians to jump in and out of the expected workflow. It has been demonstrated that a defined “workflow” that physicians agreed upon during development most commonly erodes after the first several steps. (1,2) The ability to step back into the workflow after a short detour needs to be readily available in an intuitive and simple manner. There should also be flexibility in how the EHR is used, both to conform to an individual’s working style as well as to respond to the demands of a clinical situation. Along these lines, but not limited to them, is the ability to have more than one patient record open with safeguards that ensure the correct data is always entered into the right patient’s chart.

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2022 Clinical Workflow Flexibility Challenges in the EHR: Defining the Problem (Part Two)

In our previous articles, we described an “as-is” exercise with the EHRA workgroup and the HIMSS Physician Committee members where one issue became the focus: the flexibility of workflows. This series of blog posts reviews the results of that exercise and describes a path forward. This article will focus on the second of the two topics: Personalizing the EHR and Understanding the Patient.

Personalizing the EHR
A common thread for “personalizing the system” is that while there are often tools available to personalize and configure the system, they can be difficult to discover, challenging to scale and share, and overwhelming to interact with in the clinician workflow. If it were simpler to personalize or optimize one’s own EHR experience, there would be little need for an organization to conduct optimization exercises after the initial implementation. After spending eight or more hours in formal training, and then significant time post go-live with practical EHR use, having some simple means available for self-configuration might remove additional hours of optimization, which will in turn reduce physician frustration.

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2022 Clinical Workflow Flexibility Challenges in the EHR: Defining the Problem (Part One)

Defining the Problem: Flexible Workflows in the Electronic Health Record (EHR)

The Electronic Health Record Association (EHRA) Clinician Experience Workgroup met with the HIMSS Physician Committee shortly after HIMSS 2021 to discuss areas of shared focus and create plans for collaboration over the next year. Our groups already agree on the quality, safety and efficiency-of-care benefits, to both providers and patients, that EHRs have brought. We also agree that there is more work to be done to improve and deepen the impact of these tools on care delivery, documentation and clinician satisfaction. The focus of our meeting was to decide where action was most urgently needed to raise the bar for EHRs. One topic that was of interest was the sense that EHRs lacked flexibility within clinical workflows. This series will provide a summary of our discussion, the areas of focus we agreed upon, as well as some of the promising solutions we discussed.

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What Role Can Health IT Play When an Epidemic Meets a Pandemic?

By David Bucciferro (Foothold Technology), co-chair of the EHRA and the Opioid Task Force, and Renee Han (Epic), Opioid Task Force member

Over the past several years, community service and health professionals have fought hard to gain ground in the battle against the opioid epidemic. From 2017 until 2020, the number of patients receiving buprenorphine, methadone, or naltrexone – common medications for opioid use disorder (MOUD) – consistently increased as more patients at risk for OUD and overdose were identified and treated, according to a report from Epic Research

First-time MOUD, buprenorphine, and naltrexone patients over time. Solid colored capsules show the last observed value. Dashed outline capsules show the predicted value for May 2020. (Source: Epic Research.)

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Genomic Data Sharing Policies Must Protect Patient Privacy, Minimize Risk

By Michael Saito (Epic), Chair & Nam Nguyen, (Allscripts) Vice Chair, EHRA Privacy & Security Workgroup

The National Institutes of Health’s (NIH) ongoing objective of sharing research data sets to facilitate additional study is something EHRA member companies wholly support – as long as it protects patient privacy, ensures patients can provide informed and meaningful consent for use of their data, and minimizes the risk that patients’ genomic and other health data can be re-identified or misused. 

To that end, we took advantage of the NIH’s recent Request for Information (RFI) on the proposed updates to and long-term considerations for its Genomic Data Sharing (GDS) Policy to provide feedback in the key areas of de-identification, potentially identifiable information, and data linkages.

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