In a recent blog post, experts from UCSF’s Center for Digital Health Innovation advocate for calling EHRs “connected health records” rather than “comprehensive health records,” a term used by vendors like Epic.
The Health Information Technology for Economic and Clinical Health (HITECH) Act altered the face of medicine, launching a shift from paper-based medical records to the national adoption of electronic health records.
That was back in 2009.
Today, more and more activities and topics are encompassed in the term “health.” There are social determinants of health, genomics, population health and personalized medicine, to name a few. Thus, “the construct of electronic health record as electronic filing cabinet remains deficient,” the blog post notes.
With this in mind, EHR vendors have been proponents of the “comprehensive health record,” which keeps track of more data and use cases, as opposed to the phrase “electronic health record.” Epic CEO Judy Faulkner touched on the term at the company’s Users’ Group Meeting last fall. Cerner, eClinicalWorks and athenahealth are also looking to expand what’s all included in an EHR, according to Healthcare IT News.
But the UCSF blog post authors — Aaron Neinstein, director of clinical informatics; Mark Savage, director of health policy; and Ed Martin, director of technology — don’t like the phrase “comprehensive health record.”
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“This concept misses the point,” they wrote. “… [N]o electronic health record can be ‘comprehensive.’ Interoperability is not and must not be defined by being able to pick up and move a giant digital stack of records from one hospital system to another, with the hope that the patient’s various providers will all be able to accumulate everything, like a cartoon snowball rolling downhill, into one ‘comprehensive’ record.”
Rather, they prefer the term “connected health record.”
It “achieves true completeness by focusing on the dynamic conversation, teamwork, interconnections and diverse data sources inherent in managing health and healthcare today,” according to the blog post.
Their version of a CHR is more about interoperability and allowing a patient’s entire care team to interact and update information.
“In the world of the connected health record, a patient at home with cancer who gets a fever will have her temperature data transmitted to her primary care physician, her oncologist, her home care nurse and her family caregiver,” the blog reads. “Recommendations and changes in care plan from any one of those providers will be communicated to and accessible automatically for the entire care team.”
Organizations like the Office of the National Coordinator and laws like the 21st Century Cures Act have emphasized the need for interoperability, the blog post notes. Plus, the authors say EHRs will only become more complicated if they grow to include more use cases and information.
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