How EHR Interoperability Facilitates True Digitization of Healthcare

While many healthcare providers have adopted electronic health record (EHR) systems—the vision of connecting the care continuum by having interoperable systems is still largely unrealized.

The hard truth is that despite the hundreds of millions of dollars spent on these advanced systems, our internal data shows that 70% of healthcare institutions still rely on fax machines for transferring patient records.

Not only that, but the administrative burden still exists, and when you add the rising operational costs and staffing shortages, there’s a dire need for a simpler solution.

In this article, we’ll explore why EHR systems have fallen short of realizing the true modernization required to provide better care and outcomes throughout the healthcare system and how a few healthcare companies have overcome this issue.

Challenges of paper-based processes in healthcare

Let’s look at how legacy systems and paper-based processes are burdening providers:

EHR systems aren’t built with the provider in mind

Previously, EHR systems were built with one goal in mind: digitization. It wasn’t about streamlining the provider’s workflow. The goal was to move paper-based patient records to a digital system that started with recording details for billing but eventually included the patient intake and consent process. 

It’s also why it takes months or years to achieve 100% adoption. This is why, even now, there are still many paper-based workflows in place. 

Administrative burden on providers has increased with time

While EHRs were supposed to take the burden of administrative workload, it has done quite the opposite. Providers and administrators are doing more paperwork instead of spending time treating the patient. More than 40% of healthcare workers spend five hours weekly just faxing and printing documents.

When you consider that there’s a healthcare staffing shortage right now, this only worsens this situation. Data from the Association of American Medical Colleges (AAMC) indicates that by 2034, we’ll face a shortage of 124,000 physicians. Plus, there’s a 37% increase in labor costs between 2019 and 2022 due to high demand in the market. Ultimately, these issues put more pressure on healthcare companies.

Lack of effective change management processes

Management doesn’t anticipate how much work goes into making a new system a habit for their employees. For instance, if you introduce a new e-signature platform within your EHR, providers don’t have to get documents signed physically, which requires adaptation to a newer process.

Dr. Paramjit Chopra, CEO of MIMIT Healthcare, mentions that this change needs to be communicated and managed before you think of the implementation process.

“The challenge is that people think you’ll buy the software, and it’ll just magically transform everything,” said Dr. Chopra. “But you need the right structure, the right processes, and the right people to do this. People don’t mind change, as long as you’re not changing them in that process.”

For instance, MIMIT Healthcare integrated a learning management system within its interoperable patient engagement platform, allowing providers to access resources anytime. This also improved the ROI on the software investment, as adoption increased with time.

Internal teams are living in silos which hampers interoperability

Within healthcare organizations, there’s a disconnect between internal teams like the care coordinator arm, clinical arm, and information technology (IT) arm. For example, if a patient comes in, the administrative staff has a different patient intake and registration process. In contrast, the clinical staff uses another system to record diagnostic information. 

Both these teams are catering to the same patient. However, the information flow between them is abrupt. 

“For 30 years, I've been putting stuff into EMRs—nothing comes back,” Dr. Chopra explained. “Patients are still frustrated. What's going on here?”

“But when you step out of healthcare into Amazon or Costco, you’ll realize we live in a digitally transformed world today. If you have mice at home, people are not looking for the fanciest mousetrap. They want to get rid of mice. Amazon centered itself on the customer and made sure you get great value. And its logistics are tremendous. Why can't medicine be like that?” 

It’s common practice to ask staff to carry out additional work to ensure that the data is captured in a way that the data flow is seamless. This approach can lead to errors in data capture, unnecessary burdens on hospital staff, and delayed patient diagnosis.

There’s a need to create digitized, paperless solutions that unify healthcare records and make them accessible throughout the care continuum.

Healthcare interoperability is slowly becoming a reality

Even when newer EHRs and supporting systems were introduced, they weren’t created with interoperability in mind. However, once providers and institutions realized that it compromised patient safety and patient outcomes, more work began in the interoperability sector. 

For instance, a recent Docusign study found that 63% of providers agreed that their patient consent process was risky due to poor document storage and retrieval capabilities. In addition, 46% of providers agreed that limited EHR integration and interoperability prevented digitization. So there needs to be more work done in this regard.

A behavioral health provider removed data silos in their organization using interoperable EHR systems. Instead of using different systems to capture data at various stages of care delivery, they used an interoperable system to facilitate data transfer. 

When they used Docusign to get consent forms signed, the care coordinator accessed the forms immediately and engaged the patient in the post-care process without waiting for another staff member to add it to the record manually. This shows the value of interoperability in healthcare. The entire care system is connected and manual work that resulted in delayed care delivery and unnecessary staff burden is removed.

Recent legislation like the 21st Century Cures Act and improved technological solutions in the market are also bridging the interoperability gap.

For instance, workflow inefficiencies in EHR systems make it challenging to match patient records and verify sources, as this has to be done manually. Administrative staff would have to use additional steps to ensure that the correct records have been added to the correct chart to prevent errors. 

This also prevents the real-time sharing of patient data, prolonging the time for diagnosis. However, the 21st Century Cures Act mandates the use of open APIs as long as they comply with HL7 FHIR standards to allow for the smooth exchange of information.

The goal is to use technology that expands the capabilities of current EHR systems and looks at the entire care continuum, not just the process of patient intake or record keeping.

Investing in a patient-centric system that goes beyond current antiquated processes

Dr. Chopra emphasizes putting the patient at the center of every workflow. This also addresses the goal of achieving the Quintuple Aim through their services. 

The Quintuple Aim is a framework that allows healthcare organizations to provide care in a way that reduces the burden on providers and patients alike. It addresses the following areas:

• Improving the patient experience

• Improving the health of entire populations

• Addressing provider well-being concerns

• Reducing operational costs

• Promoting health equity and care team collaboration

Dr. Chopra mentioned how he started his own company to resolve service delivery challenges in healthcare. His company built a patient engagement platform that takes a 360-degree view of the patient journey and uses interoperable systems to deliver care—describing it as the Amazonification of care.

“We built a clinical operations model just like flights. No flight in this world takes off without a flight plan and or a flight coordinator,” explained Dr. Chopra. “All patient journeys and more complex than flights have a care plan and have care coordinators, and we started applying that one by one so that patients have great outcomes.”

“The EHR is about the disease, diagnosis, and medication. But when they work with us, each patient has a care coordinator and gets a full care team. And this is built and baked into the practice, like with Amazon. That’s why I love the phrase Amazonification of care.”

For instance, when a patient comes in for a procedure and wants to know the cost, the platform has everything in place already. The eligibility criteria, medical records, and billing codes are available, making it easier to fetch that data for them. Next, when the surgery is done, providers can directly upload the care plan, which is automatically distributed to the care coordinator and billing department—significantly reducing the stress on the patient and provider.

By integrating Salesforce Health Cloud, Tableau, and Box, the company achieved a 459% annual ROI, allowing it to recuperate its investment within three months. Additionally, by integrating Docusign eSignature, they could reduce labor costs by 35%, increase patient revenue by 20% and increase security assurance by 50%.

Interoperability is key to an effective EHR system

When every second in a healthcare setting can make a difference in patient outcomes, using digitized systems that talk with each other is critical. Paper-based processes have hindered the provider’s ability to deliver care on time, and the inadequacies of the EHR system only add to the problem. 

Issues like lack of data transfer and inadequate digitization of patient records are still rampant despite the existence of EHR systems. This is why it’s time healthcare companies invest in solutions that don’t just integrate but are interoperable with their EHR systems, as it allows for seamless data exchange, removal of paper-based processes and alleviates the burden it’s putting on patients and healthcare staff.

Learn more about Docusign solutions for healthcare and how they work within the realms of your existing systems.