What percent of hospitals use electronic medical records

Future of EHR/EMR: Experts Predict Trends in 2022

Recently, the world has been full of surprises for the healthcare industry and the future of EHR and EMR. The arrival of COVID-19 showed just how valuable digital solutions are for solving the numerous challenges facing healthcare institutions. Digital technologies took center stage, and they are here to stay. Electronic medical records, managed with EMR software and electronic health records, handled by EHR software, have revolutionized how patient records are entered and processed.

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Telehealth has become the norm rather than the exception. The futures of EHR and EMR hold a lot of promise with better care for patients and ease of providing superior care with physicians and medical facilities using digital technologies. The question now is, what are the EHR and EMR trends we can expect in 2022? We spoke with experts in the healthcare tech industry to find out what they think about where electronic medical records are going in 2022 and beyond.

What is included in this guide:

• Key Takeaways
• A Brief History
• Implementation Hurdles
• Future Trends
  • Accessibility
  • Integration and Interoperability
  • Searchability and Ease of Use
  • Standardization
  • Changing Dynamics
  • Patient-centric Engagement
  • IoT, AI and Voice Recognition
  • Reducing Errors
  • Blockchain and EHR
  • 5G and Big Data
  • Wearable Devices
  • Real-time Data and Analytics
• The End, for now

Key Takeaways

• EHR/EMR adoption rates are higher than ever at around 89%.
• Documentation issues, such as risk-based management codes and use of modifiers, remain a concern for physician practices.
• Experts think that the greatest improvements in EHR will be in patient engagement, accessibility, regulation and standardization.
• Big changes like AI, blockchain, clinical decision support (CDS) and the presence of tech giants like Epic and Cerner are on the horizon for the healthcare industry.

A Brief History

Before we talk about the future of EHR and EMR in healthcare, let’s discuss where such software came from and where it is today. Before the mid-2000s, if a patient was admitted to a hospital, some poor intern would have to run down to the records room and dig through hundreds of thousands of files to find a patient’s previous record – if the patient even had one.

It was a logistical nightmare, and most people in the medical industry chuckle when recalling those earlier days. Interoperability between hospitals was unheard of and wouldn’t arrive until much later.

The first step to modernize EMRs was to digitize them. In 2004, President George W. Bush signed an executive order designed to oversee the development of health information technology infrastructure that included adopting EMRs and EHRs. Since the Obama administration emphasized technology to revitalize the economy in 2009, the government has backed software tools that give doctors easier access to patient data.

In 2016, the government began an EHR implementation incentive program that offered kickbacks and benefits to providers that utilize these systems. The program’s success is undeniable; in a recent survey of national electronic health records, 89.9% of physicians reported using an EHR or EMR system. Diagnostic tests and medical imaging have generated tons of patient data.

Wait, you might be thinking – you just said EHR; I thought we were talking about EMR? Well, yes and no. Although there are technically some differences between EHR and EMR, those differences are superficial. For the purposes of this article, we’re going to take a page out of the industry’s book and use them interchangeably.

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Implementation Hurdles

If EHR and EMR systems see universal use, they must be amazing products, right? Unfortunately, that’s not always the case. As EHR trends are concerned, different studies have resulted in different findings, but one thing is fairly consistent: physicians hate EMRs.

And they have good reason to. According to Kimberly Reich, Privacy and Compliance Officer for Lake County Physicians, “Cost continues to be the most significant and major barrier that affects healthcare practitioners from adopting EMR.” While large hospitals can foot the bill for a system that costs thousands (or hundreds of thousands) of dollars, the price point of many EMRs continues to be prohibitive, especially for small practices.”

And the cost doesn’t only lie in software. The human cost of these systems is exorbitant. Jeff Riggins, health IT expert and digital media consultant at Drury University, sums up the issues with current EMRs quite well:

“Sadly, most EMR software is terribly inadequate. They were built on obsolete platforms with little thought dedicated to user experience. Most EMR packages started as billing systems slowly adding clinical components to gain market share. The design phase was largely overlooked as the functionality of the system was all the government had created guidelines for. This is why physicians complain they have to click 30 times to give a patient a sleeping pill.”

The combination of excessive documentation expectations and poor UX results in physician burnout and overwork. Burnt out physicians, nurses and other staff often seek ways to reduce their data entry workload, resulting in mistakes or cutting corners. According to Douglas W. Bowerman, MD

The medical record has become unreliable due to inappropriate use of features like copy-paste. With many doctors, you don’t bother reading their note because you don’t know if you can trust it. This creates inefficiency because you have to go to the source to verify it. It’s a big safety and efficiency issue. This means that patient records are not always correct, reducing the value of the EMR system overall and contributing to errors in patient care. The future of EHR needs to change, and judging by some of the issues currently facing it, it needs to change in big ways.”

A 2021 report by Deloitte highlighted the other hurdles like socio economic shifts, care model innovations, collaborations and interoperability of data.

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Before we dive into some upcoming trends that paint a granular picture of the future of electronic health records, here are some interesting statistics:

• About 66% of users search for information about their medical issues on the internet.
• Nearly 88% of physician appointments are booked via phone.

With COVID-19 hitting the stage, the adoption of virtual health has become a necessity.

EMRs and EHRs have advanced in leaps and bounds since their invention in the 1960s, and they still have a long way to go. What does the future of electronic medical records hold?

Soon, EMRs will be focused on a value-based care model as the industry switches over from volume-based models. Humans will continue to get sick and need care (at least until we all upload our consciousness into robots – but that’s an article for 3019). Here are some electronic medical records trends to keep an eye out for in the coming years.

Accessibility

Bowerman predicts we will see a “continued trend towards accessibility” in EMRs, both in terms of how we access them – on mobile, for instance – and who can access the software.

The main thing holding practices back from adopting EMRs has to do with accessibility. EMRs are incredibly expensive – up to six or even seven figures for the total cost. While hospitals and large multi-facility networks leverage government incentives to implement EMRs, the same is not true of smaller practices.

According to Amy Leopard, partner and Health IT specialist at Bradley, “Post-acute and home healthcare providers have not had the same financial incentives that hospitals and physicians enjoyed, so their take up rates have been lower.”

Reich agrees. She argues, “a lot of people lack time along with the lack of knowledge and training in health IT,” which makes utilizing these solutions correctly a challenge. And there is a big difference between using one right and just using one. EMR vendors will need to make their products more accessible to a wider range of practice types if they want the illusion of the hated EMR to go away.”

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Integration and Interoperability

Another serious issue with EMRs is their lack of ability to integrate with other systems. When a patient comes into a hospital, for example, that hospital needs records from outpatient practices and any other hospitals this patient has visited previously to get a full picture of their health.

This accessibility seems like it would be a top priority for EMR developers, but that isn’t the case. Physicians and hospital staff must manually enter data, upload unsearchable scans of information or figure out a workaround to enter crucial patient data.

Riggins says:

Dissatisfaction with EMR software is driving burn out across all care settings. The lack of interoperability caused by an absence of data sharing standards, along with organizations engaging in data blocking, have created problems for patients who seek care from multiple organizations. This stress is shared by the clinicians who care for them. Without a set of robust standards for data storage, access and sharing, interoperability will continue to be the elusive unicorn of the EMR world. I hope we will see a massive public/private partnership focused on reducing the regulatory burden now placed squarely on clinicians and instead create an environment for progress toward true interoperability.”

“This is the year where interoperability is getting a lot of attention from the government, providers and vendors. Hopefully the needle will move, particularly where interoperability can help gather data for the physician that is useful at the point of care.”

If EMR vendors pay any attention, interoperability and integration features will be at the top of their list for upgrades and changes in 2022 and beyond.

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Searchability and Ease of Use

It’s not just the ability to use an EMR with other EMRs that’s causing trouble – just using one in general is a hassle. Bowerman mentions with some incredulity, “I have no explanation for the discrepancy between the quality I know we’re capable of producing and the quality of what we have at the present. There needs to be more ease of use in terms of navigating through data.” Despite advancements in technology, EMRs seem to be lagging in user-friendliness and ease of use.

Leopard agrees:

The biggest challenge at the moment is to address the physician workflow and usability pain points. There is a vast recognition that physicians are overburdened with the documentation requirements. EHR and healthcare technology generally need to be better optimized so they can avoid routine clerical functions and interact with patients more fully.”

If you can’t find, use and organize an electronic health record better than paper files, what’s the point? EMR vendors need to keep their users in mind and take physician feedback seriously in the future if they want to shake the reputation of being cumbersome and disorganized.

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Standardization

One way to achieve legitimate ease of use is through standardization. The current standards that regulate EMR are very lax. For instance, according to Reich, one vendor had to pay $155 million in settlements because it gave customers kickbacks for falsely claiming it met meaningful use certification requirements.

If vendors are going to be held accountable for providing the features users need and upholding meaningful use standards, there have to be more regulations. Reich explains that to make this happen, “data standards should be consensus-based, transparent, well-documented and openly available in a nondiscriminatory way.”

And it’s not just data and features that need standardization. Bowerman wants to see separate interfaces for physicians and medical billing coders. Physicians and billers need access to diverse, and often unrelated, pieces of patient information. When both user groups see the exact same patient information screens, it can cause life-threatening miscommunications and confusion.

Standardizing differences in how you enter conditions for billing vs. treatment – or separating those views altogether – will go a long way to make systems easier to use.

Changing Dynamics

Rapid innovations in technology are already influencing the future of electronic medical records. As AI and virtual assistants like Alexa and Siri become more accessible and powerful, they will begin to appear in health IT fields. Leopard thinks this will happen soon, and in a big way:

Virtual assistants are also coming online to help with those physician burdens, in particular the aspects of the physician workflow issues that computers can streamline. For patients, the big development is expanding online or smartphone access to your health information and the ability to combine information from different providers and update it automatically.”

Mitigating the main issues surrounding EHR use is a challenge, but shifting data-entry tasks away from overburdened physicians and staff is a start. Other experts think EMR vendors will have to look beyond a patch for the problem.

Riggins says tech giants entering the healthcare space will make waves:

“Apple, Google and Amazon are all entering the healthcare space. Their presence will pressure EMR vendors to innovate or perish. The large tech giants have the funds to invest in R&D and leading edge UX and UI without endangering their bottom lines. They have witnessed the problems created by the lack of interoperability between systems and will not make those mistakes. It will be exciting for consumers and clinicians and not so exciting for current EMR companies.”

This competition will force EMR vendors to make significant alterations to their systems or risk losing their competitive edge. There’s no surefire way to know how it will play out, but big changes are definitely coming.

Patient-Centric Engagement

Consistently growing takes more than diagnosing your issues and using technology. Ensuring patient engagement throughout the scheduling and treatment process is key. Patient outreach and making content available through patient communities is one method to boost engagement.

Ownership of patient data is an important benefit. Including data from wearable smart devices has become paramount as these details give physicians insight into their patients’ health. Emailing appointment reminders for appointments can reduce cancellations while increasing patient engagement.

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IoT, AI & Voice Recognition

IoT devices, especially in the healthcare market, are seeing increased usage. In fact, the global market for IoT-enabled healthcare devices is expected to jump from 2020’s $50 billion to nearly $135 billion by 2025.

Several practices also integrate artificial intelligence to help physicians make diagnoses and identify patient health trends. Many companies are conducting research to add voice recognition using AI to EHR software. Tools like Northwell Health and Allscripts have an agreement to add voice and AI to their EHRs.

Integration of Natural Language Processing (NLP) into EHR systems will improve physician efficiency and patient treatment. AI systems that use natural spoken language to understand physicians are the future.

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Reducing Errors and Improving Workflows

ECRI’s report about the Top 10 Health Technology Hazards mentions medical error prevention as something that EHRs should address.

With paper prescriptions, illegible handwriting of physicians was blamed for errors. The use of computer-based charts has reduced mistakes, but reliance on digitalization can cause problems with dependency on computers to supply correct dosages.

In 2013, a patient was prescribed 38 tablets, but it was actually an overdose for a 16-year-old. Such errors are more common than we realize. Bob Watcher wrote about this dark side of health IT in his book.

One issue EHR systems struggle with is that physicians get too many notifications, resulting in less attention for patients. Before they are sent for medical and radiological imaging, patient implants may not be included in the system since current EHRs don’t have a standard place to note details.

Errors have serious consequences and can impede the quality of treatment and medication given to patients.

Blockchain and EHR

Though blockchain technology is more popular for its role in cryptocurrency, it is seeing recent use in healthcare. Blockchain uses cryptography to secure EHR data and makes it available only to those with access to it.

For example, blockchain can validate clinical trial and claims results, track medicine distribution, authenticate prescriptions and prevent insurance fraud. Smart contracts can also use blockchain to take action based on predetermined results, reducing human involvement. The use of blockchain has just begun, though several EHRs have incorporated it to ensure security, scalability and confidentiality.

5G and Big Data

5G is the next innovation on the horizon, and it will create an upgrade in transmission bandwidth. Everyday interactions on the Internet of Things (IoT) exchange huge amounts of data. 5G’s phenomenal increase in internet speeds and device loads will impact all facets of data, software and how people interact with devices. We could even see things like smart cities and autonomous vehicles become the norm.

Healthcare, though, isn’t ready for its blazing internet speeds. As of now, healthcare records, like lab results, notes and scans, haven’t been completely assimilated across hospitals, clinics and offices.

These documents are often incompatible or in different formats, making communication between different EHR software difficult. Until the industry determines data storage format standards leveraging 5G technologies across EHRs will remain a bottleneck.

Wearable Devices

Overall, the amount of connected wearable devices is expected to surge in the coming years. The wearable medical tech market, valued at $16.6 billion in 2020, is expected to grow at a CAGR of 26.8% through 2028. With the increase in popularity of wearable devices, patients have become more aware of their healthcare metrics.

Data integration from wearable devices to EHR systems offers opportunities to provide better patient care. Wearable devices, more popularly known as wearables, have sensors that measure activity levels, steps walked and other environmental indicators. They come in many forms, including smartwatches, smart goggles and fitness trackers, and push the data to apps on users’ mobile phones.

Real-Time Data and Analytics

Healthcare facilities accumulate massive amounts of patient data. Patient health and financial data lets vendors help physicians with Clinical Decision Support (CDS). Leveraging analytics algorithm predictions can solve interoperability-related accessibility issues. Data warehouse development is also an opportunity to ensure cleaner patient data thanks to automation.

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The End, For Now

The coming decade will see unprecedented transformation as digitization will become a core offering of healthcare institutions. Disruptions caused by COVID-19 have brought a silent yet visible revolution in the way patients want to be cared for and how healthcare institutions can provide superior care and patient engagement.

While no one can predict what the future of electronic medical records will look like, the combined wisdom of these experts can give us a pretty good idea. In the coming decades, we can expect to see significant growth in accessibility, integration, IoT devices and interoperability between EHRs and EMRs.

Hopefully, the industry will improve the searchability and ease of use of their products – increased EMR standardization regulation could be crucial to this. The changing world of healthcare tech, and tech in general, will continue to put pressure on the industry to change and adapt, hopefully for the better.

How do you think the future of EHR and EMR will change? Let us know your thoughts in the comments!

Contributing Thought Leaders

Jeff Riggins has worked in Healthcare IT for more than 15 years consulting with providers, clinicians, and administrators working in rural hospitals, home health and hospice agencies, family practice clinics, and specialty practices. His main focus has been implementing and supporting EHR systems across multiple platforms. His experiences in multiple Healthcare IT care settings combined with his knowledge of digital communications led him to work with Drury graduate faculty to conceive develop and deliver graduate level courses exploring the nexus of health care and technology: Health Advocacy in the Digital Age and Digital Health Communication.

Douglas Bowerman is a hospitalist at University of Rochester Medical Center. He has been a pillar of the medical community since the early 2000s. In addition to providing full-time clinical care to his hospitalized patients, he operates a private consulting business that evaluates potential medical malpractice cases involving the clinical care provided by Hospitalists. Thus far, he has reviewed over 400 cases, given 8 depositions and testified in court 5 times.

Kimberly Reich is a credentialed healthcare compliance, information management, informatics and certified electronic data discovery professional with over 25 years of experience in a variety of healthcare settings. She is a national speaker and author on the topics of healthcare operations, e-discovery and compliance. She is active member of the Health Level Seven (HL-7) Working Group responsible for review and development of the Records Management and Evidentiary Support (RM-ES) profile for the design and development of the functional profile for Electronic Health Record (EHR) systems and led AHIMA task forces and working groups related to healthcare electronic discovery.

Amy Bradley is a partner at Bradley, a boutique law firm with 10 offices in Alabama, Florida, Texas and more. She is a business advisor in information technology and healthcare law. Her in-depth knowledge of the healthcare industry comes from 25+ years in community hospital and academic medical settings.