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Prior to the HIMSS 2019 conference Signify Research published its predictions for the key themes that would reign in Orlando. We focused on four areas
- Developments in data sharing and interoperability – particularly in supporting risk stratification and the move toward personalised medicine.
- Business diversification (both product and vertical market) amongst EHR vendors as their attempt to maintain historic growth rates
- The increasing importance of telehealth at HIMSS, particularly considering recent changes to reimbursement policy within the US.
- And finally, how EHR vendors will address physician burn-out.
We have a separate insight that reviews the first and second point together and a further insight presenting some of our key telehealth related takeaways from the show. Here we focus on physician burnout, a significant theme at the show, particularly in relation to EHR product developments.
AI to Support EHR Workflow Innovation
Poor UI, long-winded data entry procedures, workflow tools that don’t speed up processes but slow them down, IT that gets in the way of the clinician-patient relationship instead of supporting it, have all contributed to much of the EHR investment seen across the US over recent years being viewed by clinicians with resentment.
Without doubt addressing these issues was a key theme of the show, with most EHR vendors announcing product developments specifically aimed at improving this.
A tour of the Cerner booth illustrated several solutions aimed at physician burnout. It announced at the show the launch of “Chart Assist”, an AI-enabled workflow tool that uses NLP to effectively “listen” to a clinician-patient discussion and input data into the EHR in real time. The AI is not limited to supporting the voice input, but also supports adapting the EHR workflow, analysing and capturing missing data from the EHR and review and validation of the patient diagnosis.
Cerner is a partner of voice recognition and NLP solution provider Nuance, which itself also announced its new AI-powered solution at HIMSS aimed at addressing physician burnout. Its Ambient Clinical Intelligence solution, or ACI, builds on the Dragon Medical One cloud platform used already to support several hundred thousand clinicians with “hands-free clinical documentation”. ACI builds on Dragon by adding assisted workflows, ambient sensing hardware, and task and knowledge automation.
Although launched in 2018, Paul Black, Allscripts’ CEO, continued to push the company’s AI-based EHR product Avenel prior to the show. Unlike Cerner’s and Nuance’s solutions, the focus is less on voice input with Avenel, focusing more on using AI to customise information and provide decision support at the point of care by prepopulating information based on clinical treatment patterns and suggesting areas for efficiency gains for the individual user, organisation and location.
M-Health and Usability
The use of voice technology and AI for EHR data entry certainly grabs the headlines, but often more subtle developments can be just as important. NextGen Health chose HIMSS to push its mobile EHR platform aimed at supporting physicians in updating EHR using mobile devices, claiming it saved individual physicians more than 12 hours a month compared to those using only its desk-top solution.
NextGen also announced it was collaborating with Availity, one of the US’s largest real-time health information networks, to offer clients NextGen¬Æ Pre-Service Solutions. The solution supports real-time access to insurance benefit verification, cost estimation, patient financial scripting, address verification and payment options, with NextGen positioning this as a step toward improving efficiency in workflows.
Although eClinicalWorks launched its health information search engine, eCW, in late 2018 and the eClinicalWorks virtual scribe, and Eva, an embedded virtual assistant at HIMSS18, CEO Girish Navini was still emphasising “the epidemic of physician burnout continuing to threaten the quality of healthcare” during this year’s show. eClinicalWorks was showcasing several solutions on its stand aimed at demonstrating tools that will help providers save time by “eliminating clicks” and “increasingly efficiency and accuracy at the point of care”.
Context aware EHR was also demonstrated by Cerner. Here tags worn by physicians were being used to allow the EHR to respond to the location of the physician in terms of the data that was presented on the screen. For example, as the physician moves around a ward, the EHR would automatically adjust which patient information was being shown depending on the location of the physician, i.e. it would show a patient’s record depending on which bed was being attended.
The Showstopper
Without doubt the use of technology, such as AI, location-based solutions, and NLP are viewed by EHR vendors as an area to differentiate and improve the provider experience and we expect to continue to see an increasing focus on this area in terms of innovation.
However, as we mentioned in our original pre-HIMSS insight, some of the lower-profile themes will be perhaps more influential short term. E.g. increased usability testing and design, vendor support for training and best practice, task-based design structures, reduced complexity, common style guides across product portfolios, better research and collaboration with clinicians during the product development phase, etc.
EHR vendors also need to be aware that if they don’t address this issue for their customers themselves, others may well step in to do if for them. Vendors such as TransformativeMed offer specialised clinical workflow tools, such as their CORE Value Suite, that sit on top of the EHR and support improving workflows. The company also uses machine learning and offers mobile solutions as part of its portfolio, adding voice input in the near future. During HIMSS it announced University of Tennessee Medical Center as a new customer, adding to a list that includes Baptist Health, Tenet, Catholic Health Initiatives and Dignity Health.
With many factors contribution to physician burn-out, no single solution is going to solve the wider issue. AI driven workflows, NLP enabling better voice interaction with the EHR, mobile EHR and context aware EHR will certainly allow for improvements in what are, in many cases, outdated, often poorly design UI. But, doing the basics well can still provide some quick wins and much needed relief for physicians using these systems.
About the author
Alex has 21 years’ experience in tech market intelligence. He leads on Signify Research’s Digital Health offerings focusing on population health management, EHR/EMR and telehealth. Prior to joining Signify he served as a Senior Research Director at IHS and as a Business Analyst/IT Project Manager in a joint NHS/Government role.
Related Reports from Signify Research
Signify Research will be publishing a new market report in this month examining the Global EHR/EMR Market across both acute and ambulatory settings. The report will provide in-depth profiles of 20 country/regional markets providing market size estimates, forecasts and a competitive vendor analysis for each. It will also examine the market by product, with particular focus on the level of success that EHR vendors are having driving additional business from these adjacent markets such as PHM and RCM. Click here for more information on this report.
About Signify Research
Signify Research is an independent supplier of market intelligence and consultancy to the global healthcare technology industry. Our major coverage areas are Healthcare IT, Medical Imaging and Digital Health. Our clients include technology vendors, healthcare providers and payers, management consultants and investors. Signify Research is headquartered in Cranfield, UK.
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