HIMSS18: Listening, Learning, Leading

IMG_6591EHRA member companies were out in force at HIMSS18 in Las Vegas, and not just in booths on the exhibit floor.

In a small conference room on the 4th floor of the Sands Convention Center, EHRA volunteer executives were meeting with stakeholder groups to discuss how EHRs can be optimized to improve usability, interoperability, and patient safety. We listened, we asked questions, and we shared our perspectives on the challenges and what the next steps could be.

EHRs & the Opioid Crisis

We were gratified to see a full room for a discussion of how to best utilize EHR systems’ data and capabilities as a tool in nationwide efforts to fight opioid abuse. EHRA formed an Opioid Crisis Task Force in January 2018 to examine how to best utilize EHR systems’ data and capabilities in this fight, and the interest of so many provider groups, state policymakers, and others tells us others see the potential opportunities as well.

Some of the ways in which EHRs can and do already contribute include integrating Prescription Drug Monitoring Programs (PDMPs) and ePrescribing of Controlled Substances (ePCS) into providers’ workflow; providing clinical decision support (CDS) recommendations of best practices, such as limiting initial prescriptions to three days; and helping identify patients who are showing pre-addict indicators.

Our task force—which includes pharmacists, doctors, and technical experts—is focused on the unique contributions that EHRs have to offer federal and state policymakers, public health officials, and providers in the thick of the opioid crisis. Our stakeholder meetings at HIMSS18 were the first of several we expect to have as we continue our work, and we look forward to publicly sharing more of our recommendations in the coming months.

Simplifying Reporting Measures

In other meetings, we met with policymakers from CMS, ONC, and Capitol Hill. We shared our customers’ early experiences with QPP implementation challenges, and aligned with other stakeholders on the need to reduce complexity of reporting measures. EHRs, some say, have turned into documentation tools rather than care enhancement. Specialty physicians, for example, don’t want to have to report measures that don’t add value to the care they’re giving.

EHR developers need to balance the needs of regulatory reporting programs with the desires of their customers. Our customers have told us they want a single framework for submitting and reporting, incorporated into the clinical workflow so the data doesn’t have to be re-entered for quality measures.

Continuing Toward Widespread Interoperability

We also discussed use cases for interoperability and the collection of patient-generated data. As expressed in our recent comments, we see TEFCA as a very expensive new framework, and it’s unclear who’s going to bear that cost. We advocate building upon and uniting existing networks—such as eHealth Exchange, CommonWell Health Alliance, Carequality, and Strategic Health Information Exchange Collaborative (SHIEC)—as a far more efficient proposal than making a substantial leap to a new system in a short amount of time, particularly since few (if any) current Health Information Networks (HINs) would qualify under ONC’s current definition of a Qualified Health Information Network (QHIN), and making that transition is likely to be a costly undertaking.

Many organizations, including EHRA, have asked ONC to open TEFCA to another round of comments.

While there’s much more to be done, interoperability is already working. Last year EHRA members collected real-world Interoperability Success Stories, showing the positive effects that many organizations are achieving today.

A Focus on Improved Usability

EHRA was pleased to be able to introduce our new Persona Library to stakeholders during HIMSS18. Developing a deep understanding of users is an important first step in the process of designing usable, safe and effective products, and we encourage organizations to use the Persona Library as a resource in their development work to gain new insight into their users, or to augment personas their teams are already using.

EHRA has had an ongoing commitment to usability, demonstrated in our EHR Developer Code of Conduct and other projects such as the EHR Design Patterns for Patient Safety. Our goal for the new Persona Library is for this free resource to also make a positive impact on the development and implementation of health IT products.

The library launched with 11 persona templates—ranging from Hospital Nurse to Regulatory Compliance Director to Medical Assistant—with plans to add new personas in the future.

Continuous Improvement

Data show that healthcare is far safer since EHR use became widespread. It’s also accepted that patient safety is a shared responsibility, and we’re committed to working collaboratively toward even better care. Provider groups, patient safety advocates and others tell us they want more out of EHRs, and it’s our intention to continue to move forward to enhance patient care through the use of health IT.

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    Kasey Nicholoff
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