The American Medical Association is making mHealth one of the priorities in its call for a more user-friendly electronic health record.
Referencing a 2013 study from the RAND Corp. that highlighted significant physician discontent with EHRs, the nation's largest physician advocacy group called for changes to "EHR systems that have neglected usability as a necessary feature." AMA officials unveiled eight priorities designed to improve provider adoption.
“Physician experiences documented by the AMA and RAND demonstrate that most electronic health record systems fail to support efficient and effective clinical work,” AMA President-elect Steven J. Stack, MD, said in a press release. “This has resulted in physicians feeling increasingly demoralized by technology that interferes with their ability to provide first-rate medical care to their patients.”
AMA officials noted the federal incentive programs mandate that physicians adopt EHR technology, but those programs have instead been so challenging that physicians are more inclined to accept penalties or ignore cash bonuses than embrace the technology.
[Related: With so many mobile apps is the EHR even necessary anymore?]
“Now is the time to recognize that requiring electronic health records to be all things to all people - regulators, payers, auditors and lawyers - diminishes the ability of the technology to perform the most critical function - helping physicians care for their patients,” Stack said. “Physicians believe it is a national imperative to reframe policy around the desired future capabilities of this technology and emphasize clinical care improvements as the primary focus.”
In its call for a better EHR, the AMA listed the following priorities:
- Enhance physicians' ability to provide high-quality patient care;
- Support team-based care;
- Promote care coordination;
- Offer product modularity and configurability;
- Reduce the cognitive workload;
- Promote data liquidity;
- Facilitate digital and mobile patient engagement; and
- Expedite user input into product design and post-implementation feedback.
Making mobility a priority
In its accompanying 12-page report, titled "Improving Care: Priorities to Improve Electronic Health Record Usability," AMA officials said the healthcare industry "remains the exception rather than the norm" in digital interaction. Physicians aren't creating portals through which patients can securely access their medical records, and may be forced to spend tens of thousands of dollars to do so to meet Meaningful Use requirements.
"Many of these requirements could be facilitated through digital patient engagement, but most EHRs are not designed to support it," the report noted.
Furthermore, the report noted that patients are taking advantage of wearable sensor technologies that could be used for real-time monitoring and tracking. "Over time, it is anticipated that wearable sensor technologies will become an important feature of the health IT ecosystem," the report stated. "Current EHRs offer limited or no capability to download and synthesize data from these technologies."
In its report, the AMA noted that mHealth is "expected to play a fundamental role in new payment and care delivery models," and it called on EHR providers to incorporate patient-fed data into the newly designed EHR.
"Patients themselves can be useful sources of their own medical information when well-designed tools and processes are put in place," the report said. "Whether for health and wellness and/or the management of chronic illnesses, interoperability between a patient’s mobile technology, telehealth technologies and EHR will be an asset. EHR vendors must anticipate this when incorporating interoperability in the design of future products."
Pressing the initiative
AMA officials said they would be working with physicians, vendors, legislators, researchers and healthcare administrators to push these priorities.
Among those advocating for the ADA's new initiatives is Steven Steinhubl, MD, director of the Digital Health program at San Diego-based Scripps Health and a member of the AMA Advisory Committee of EHR Physician Usability.
"Given the rapid growth of digital technology in healthcare, whether for health and wellness, or the management of chronic illness, a comprehensive health information technology strategy must include interoperability between a patient's mobile technology, telehealth technology and the electronic health record," Steinhubl said in the AMA press release.
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