Health Trends 2021: The Electronic Health Record Hits Its Stride

Digital health records were supposed to make a clinician’s job easier. Are they ready to deliver on that promise?

The dream of an electronic health record (EHR) — born in the visionary 1960s — imagined one seamless, universal home for a patient’s medical history. The actual rollout has been a bit rockier. Over the past decade, EHRs have contributed to exhaustion and burnout^1,2,3 among health care providers, increased costs for software and maintenance⁴ and presented interoperability issues.⁵

In 2021 and beyond, EHRs will continue to face these growing pains. Innovations in both software and integration are already changing some of their more vexing features. Here is what the next year may bring:

Patient Portals Get Friendlier

Starting on April 5, 2021, all patients will be able to freely access their own medical records, a stipulation of the 21st Century Cures Act.⁶ While patients have always been able to request their own medical records, the Cures Act will enable new patient access provisions and better interoperability, making it easier for patients to get what they need.

This shift will largely be mediated through EHR software. Epic, one of the nation’s largest EHR companies, has been fine-tuning MyChart, a feature that allows patients to not only securely see and share their data with providers, but also navigate appointments and information about health care costs.⁷

According to Sharon Vitti, President of MinuteClinic and Senior Vice President of CVS Health, MyChart is becoming an “indispensable tool” not only for clinicians but the patients they serve. Since the pandemic landed last spring, MinuteClinic used MyChart to bring some services online, including virtual visits with providers, and it is one of the principal ways for patients to see COVID-19 test results.

Pre-pandemic studies suggest these kinds of patient portals may even boost adherence and offer more ownership of the treatment journey, though how that might relate to clinical outcomes isn’t yet clear.⁸

EHRs Learn to Cooperate

Fragmentation of health data across multiple, incompatible systems has been a headache for consumers and providers since day one. A 2017 analysis of more than 500,000 providers identified at least 18 distinct EHR platforms in use,⁹ and a 2018 study found that most hospitals don’t use patient data from outside their own system.

That may soon change. In recent years, both Epic and Cerner, the two largest EHR companies, have launched initiatives to facilitate the safe, digital sharing of data — even among providers who use different systems. One promising technique is natural language processing, a subfield of artificial intelligence that focuses on communication and translation.¹⁰

“Interoperability has been a big area of our focus. It has to be,” says Vitti. “Retail medical clinics share information with hundreds of providers and medical institutions. We can’t exist in a silo.” Since 2014, her teams have shared 128 million records across 10,000 health care locations in all 50 states, through Epic’s Care Everywhere program. And other areas of the company, such as the Coram Home Infusion arm of CVS Health, are launching Epic modules of their own.

Unsounding the Alarms