May 14, 2021
In this podcast, Dr. Chris Mast, Vice President of Clinical Informatics with EPIC, discusses how electronic health medical records (EHRs) are essential to today's modern day medical world, about implementing and using an EHR for improving patient care, and what the EHR future holds for healthcare.
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The importance of medical records has grown in the last 100 years, starting with the first paper medical records developed in the 1920s. Even back then, standardization was important, the American College of Surgeons established an association to achieve just that. In 1965, Medicaid and Medicare were developed and pushed the development of health information systems. The 1970s brought computerized physician ordering systems. The first information system was also rolled out in the University of Vermont Medical Center's gynecology unit. In the 1980s, growth in the computer world led to new possibilities in healthcare. Personal computers became more affordable. Dragons systems developed voice recognition software and by the late 1980s, Windows software was developed. From 1990 to the late 2000s there was the boom of the World Wide Web, ICD-30 coding, and legislation for the increase of electronic health records (the HiTech Act). Between 2008 and 2015 electronic health record adoption doubled.
EPIC is a privately owned company, which Dr. Mast states has allowed the company to focus on the long term, making sure that the software is a joy to use, and provide value to healthcare providers.
EPIC is an integrated comprehensive electronic health record system that offers many different functions to promote better patient and health care interactions. The features of EPIC provide a one-platform system, thereby eliminating the multiple database platforms used in the past or are still being used today.
One of the big benefits of EPIC is the ability to share pertinent patient information across organizations that both work with EPIC. However, with increasing interoperability (much like cell phones bounce off other network cell towers), communication between different EHR systems increase. This interoperability will only increase as standardization of data, like how a specific diagnosis - like heart failure is coded, improves. Dr. Mast states, "playing the percentages, you will be able to connect, if not now, in the near future".
The interoperability of EPIC assists in promoting care everywhere as well as the newer share everywhere features which is a limited one-time access to care everywhere for the non-EPIC health system evaluating a patient.
Connect customers, organizations that use EPIC software in partnership with another organization, benefit from a move-in ready EHR where they can start using the system immediately. The example used, is like moving into a furnished apartment, without having to find, build or organize everything. It's already there, ready to use.
EPIC is not a tiered system. There is not a platinum or gold level status. However, not every organization needs every module available on the EPIC platform. What kind of support will an EPIC customer receive? In the Connect scenario, there are essentially two groups of assistance. The connect partner, with their knowledge and support as well as the support team from EPIC.
There is also personalization of EPIC systems to create the features and information important to the workflow of an individual clinician.
EPIC is more than just a documentation software. Within the system, there are algorithms and models that allow the computer to analyze data and predict, say, patients that are trending towards sepsis. This information can be used to direct resources earlier, intervene earlier, and improve outcomes. Another example of AI modeling would be a patient discharged with congestive heart failure, and submitting daily weights. Modeling can trend that data and predict those that might fail outpatient treatment, provide opportunities for early interventions, and again, improve outcomes.
That is the present. The future of AI in electronic health records is endless. Ambient speech recognition is currently being trialed, providing documentation, transcription and even the possibility of cueing up orders. It is the fundamental theorem of informatics at work: clinician plus computer is greater than clinician alone.
Thank-you for listening.