By Matt Duffy, Chief Product Officer
It has been said that, to a hammer, every problem looks like a nail.
In healthcare IT, electronic health records (EHR) systems have assumed the role of the hammer.
As the most prevalent system of record for a health system, EHRs do some tasks well – managing patient data, billing, placing orders and documentation, to name a few. Not coincidentally, those are the things EHRs were originally designed to do.
But a “system of record” is very different from a “system of action”. A system of record is designed to store, manage, and maintain an organization’s critical data and information. It is the primary source of truth for this information and serves as the single point of reference for all related data.
A system of action, on the other hand, is focused on enabling an organization to take action based on the information stored in its system of record and other data sources. It involves tools and processes that facilitate collaboration, communication, decision-making, automation, and task execution to achieve specific business objectives. And that’s where EHRs often fall short because they were never architected to do these things.
Consider care coordination – a complex, multi-faceted, action-oriented process if ever there was one. Health systems cannot “hammer” their way, using an EHR, to coordinate care more effectively and efficiently for each patient across care teams and sites of care. Rather, a highly optimized system of action is required to effectively automate that vital process.
It’s all well and good for a clinician to go into the EHR to look up a patient’s test or lab result, or to order a prescription. Those are straightforward, individual tasks.
But the EHR wasn’t designed to support team-based care, which is at the heart of care coordination. It doesn’t traverse different systems and technologies to pull together data from various places and it doesn’t inherently help you manage populations. For that you need a platform purpose built for care orchestration, one that complements the EHR and integrates with it to leverage the patient data that resides there.
Overuse and misuse of EHRs is common… and understandable. After all, EHRs represent a huge investment by a health system – their largest single IT purchase ever. It stands to reason that health system executives want to wring every last ounce of utility out of them.
The flip side of that coin is the tendency toward digital incrementalism – deploying hyper-specialized point solutions for a specific function, like a health system’s provider directory or patient engagement capabilities – which, over time, adds unnecessary complexity and cost to the organization’s IT stack and makes it harder to manage.
There is a middle ground. It entails a process-oriented (versus task-oriented) perspective and a platform (versus point solution) approach to technology. When it comes to things like automation, an EHR can automate individual tasks (e.g., placing an order) but to effectively orchestrate care, multiple tasks must come together to automate multiple tasks within a longitudinal process.
From a scope and complexity standpoint, think of care coordination as analogous to a passenger booking a flight on an airline. Airlines have done a great job automating that process. It’s driven by a robust platform, integrated with the back-end operational system, and includes a well-designed online interface for passengers to engage directly. (Airlines didn’t just post an app in the Apple and Google app stores and call it a day.) Today, airlines could not imagine operating without it and going back to paper tickets instead.
Healthcare providers now have an opportunity – indeed, an urgent mandate – to do the same with care coordination. The solution is “care orchestration”: provided by a platform that integrates with an organization’s real-time data from the EHR and other systems, applies clinical knowledge, and employs intelligent automation to individualize the care of every patient — at scale.
While care orchestration necessarily leverages EHR data, it is not a job for the EHR alone. Only by deploying a care orchestration platform will health systems hit the care coordination nail on the head.
Learn more about how the EHR is necessary but not sufficient.