As the adoption of the Electronic Health Record (EHR) approaches 70% of all providers, our nation’s hospitals and health systems have been rewarded for attaining meaningful use from new software, mandated by the government.
This is positive news for patients staying within the same system, as they no longer need to rely on physical files or images when moving from hospital to clinic, or from one provider to another. It also means that physicians of the same system should be able to see a patient’s medical history, whether they have a history of treating that patient or not.
But providers have been hoping that the EHR will also help them communicate better with their patients, enabling them to intervene before small medical problems escalate to the point of a hospital readmission and helping them boost patient satisfaction scores.
Unfortunately, the EHR alone will never accomplish this.
Pros and cons of the EHR
EHRs represent a necessary step forward for hospitals and health systems in terms of keeping a comprehensive record of patients’ medical histories. They also offer providers insights on health and disease trends across large groups of patients, as they include demographic information.
Digital record-keeping has made life easier for patients, who previously relied on physical medical records alone when moving from one physician to another. If a patient traveled — which most people do without bringing along their entire health history — he or she would need to start from scratch with any medical professional they visited during their trip.
Providers have also benefitted from digitizing patient records. Updating and sharing records in an electronic format—as opposed to paper records kept with sometimes illegible handwriting—has meant better efficiency and a drop in repeated or unnecessary procedures.
But EHRs have hardly been a panacea when it comes to saving and sharing medical information. Patients have complained that the data entry these records require divides their physician’s attention, and keeps them busy filling out forms when they should be asking and answering questions.
There have also been concerns about the security and interoperability of EHRs. Additionally, there is growing discontent over the fact that the provider instead of the patient controls these health records.
EHR is not the same as CRM
Digitized medical records, while not a panacea, have boosted efficiency overall and reduced the number of duplicated tests and other procedures in our healthcare system. Most providers have been able to stay within government guidelines, and even reap rewards, by migrating their records to a digital format.
But many providers have wanted to see the EHR do for their operations what customer-relationship management (CRM) software has done for retail, banking, business services and manufacturing. Companies rolling out CRM in those industries and others have seen better customer engagement lead to noticeably better customer loyalty. However, patients are not customers. Patients are people who periodically visit healthcare providers out of need, rather than those who shop for something they want.
In any event, EHRs do not offer the same back-and-forth communication functionality that CRM programs do, so they do not deepen engagement in the same way.
Why EHR is not engagement
There is one main reason why EHRs do not strengthen the bond between physicians and patients: They were not designed to accomplish this.
EHRs are useful for documenting care episodes. They give providers a snapshot of a patient’s current condition, their health history, their test results and their medication regimen. But it’s only a snapshot.
EHRs are an effective record of what has already happened. This is a very important factor when it comes to determining treatment courses, but it takes a lot more than detailed record-keeping to properly engage patients.
Physicians don’t just need a snapshot of a patient’s history, as what has happened in the past is only one determinant of a patient’s future health. They need to know what is happening right now if they really want a sense of what’s likely to happen next. They need actual engagement that goes far beyond a series of snapshots of past care episodes.
Engagement means present tense, not past tense
Meaningful and effective patient engagement means having conversations about what is happening with the life and health of the patient, and continuing these conversations over long periods of time. In this way, engagement is always present tense, as opposed to keeping a detailed record of the past. Human health is a moving target, which means a snapshot will always leave out volumes of important information.
To get beyond the limitations of EHR and patient portals, providers need to think in terms of a present-tense conversation that continues for years. And they need to use the tools that will enable them to have these conversations with every one of their patients.
What happens outside of hospital walls is just as important as what takes place inside. EHRs are excluding these valuable insights and neglecting this information.
The tools to engage
Providers have done a great job of digitizing health records, but new healthcare policies — combined with the inherent desire to see patients get better and stay out of the hospital — mean that providers need to think about the next phase of technology implementation.
Now free to move beyond better record-keeping, providers need to find and implement the tools to solicit constant updates from patients via actual conversations that make the patient feel that his or her voice is being heard.
Providers will not get far if they simply blast information out to patients indiscriminately, or ask them to fill out surveys that are not tailored to their own individual situation. These cookie-cutter approaches to engagement will not move the ball for physicians or for patients.
To achieve better outcomes and boost patient satisfaction, providers need to use technology that will enable daily dialogue with patients utilizing personalized content and an empathetic tone that patients desire from their physician.
Engagement must reach far beyond the EHR — and into actual daily dialogue — if providers want to experience the benefit.