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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“No Surprises Act” Regulations Raise Concerns

By Leigh Burchell (Allscripts), Chair, & Janet Campbell (Epic), Vice Chair,
EHRA Public Policy Leadership Workgroup

The growth in high deductible health plans requiring patients to shoulder more of their healthcare costs and the lack of transparency in healthcare pricing has exacerbated the issue of patients left with surprise medical bills that many cannot afford to pay. The urgent need to address these serious issues is why the EHRA supported the No Surprises Act when it was developed and welcomed the regulations published last year as a foundation upon which it can be implemented. 

However, we have several concerns about rulemaking to date as it relates to workability and the unnecessary burden it creates for industry stakeholders. To that end, we reached out proactively to regulatory agencies to provide feedback in four key areas that we believe – based on our member companies’ experiences and our ongoing advocacy for reasonable timelines and requirements – will be informative when it comes to additional regulatory actions expected later this year. 

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TEFCA Signals Progress, With Work To Be Done

By EHRA Public Policy Leadership Workgroup

After a journey more than four years in the making, the Office of the National Coordinator for Health IT (ONC) and The Sequoia Project achieved a major milestone in the advancement of nationwide health information exchange: the publication of the Trusted Exchange Framework and Common Agreement (TEFCA) v1.0. ONC and The Sequoia Project have demonstrated their commitment to incorporating input from stakeholders across the industry, which created a process that produced significant improvements with each draft publication. We applaud the significant efforts undertaken by ONC and The Sequoia Project to collaborate with industry interoperability experts and create a framework that incorporates key principles of trusted exchange, like reciprocity, as well as a technical approach that leverages commonly adopted standards. 

For well over a decade, members of the Electronic Health Record Association (EHRA) have invested substantially in advancing the data sharing capabilities of the health IT systems used by healthcare organizations across the country with the belief that doing so will improve the quality and efficiency of health care. It is our sincere hope that TEFCA will continue to build on those investments for the benefit of patients.  

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The Case for Telehealth Reform

By the EHR Association

The expanded access to telehealth enabled under the COVID-19 public health emergency (PHE) has been transformational and served to engrain virtual care into the nation’s healthcare landscape – improving access and outcomes. Healthcare providers have risen to the challenge of meeting patients’ expectations for telehealth services by making substantial investments into new technologies that have so far carried them through the pandemic. 

However, despite ongoing surges and the emergence of new variants, many of the telehealth flexibilities that have helped dramatically improve patient access to care will expire later this year unless the Biden Administration extends the COVID-19 PHE  – which must be renewed every 90 days. Should that happen, the impact to public health programs and private healthcare delivery alike will be significant. 

Even if the PHE is extended, the uncertainty generated by its temporary nature is impacting all aspects of healthcare.

Even if the PHE is extended, the uncertainty generated by its temporary nature is impacting all aspects of healthcare. Healthcare organizations must decide if they can risk dedicating finite financial resources to maintaining the technological and clinical infrastructure required to continue offering telehealth programs at the level to which patients are now accustomed, when the possibility exists that Congress may ultimately decide against making the changes allowed under the PHE permanent.

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