The Evolution of Health Information

It is no secret that technology and the healthcare system have a slow-moving relationship. But why hasn’t technology alleviated a seemingly simple problem: storing, accessing, and sharing health data? Sure advances have been made and all health systems use an Electronic Health Record (EHR) system, but inefficiencies and frustrations remain.

To understand how to solve the problem, we need to understand where it came from

This concept of storing, accessing, and sharing health data is referred to as Health Information Management (HIM). It is the foundation of how we record information to treat patients, receive reimbursement, research treatment effectiveness, assess inefficiencies, and the list goes on.

The concept of HIM started as early as the 1920s when providers realized that documentation benefitted both providers and patients. Providers were able to reference patients’ clinical histories to better treat conditions. Documentation turned to necessity with the establishment of Medicare and Medicaid in 1965. Documentation needed to be in place for providers to receive reimbursement. Early Electronic Health Record (EHR) systems, like Eclipsys, Meditech, and Epic, began to crop up in the 1970s to not only store patient information, but also to handle scheduling and billing. The industry began to see the value in not just storing patient information for clinical documentation, but leveraging it in tandem with technology to ease administrative burden.

Up until this point, almost all patient information was stored on paper. As regulation increased, the volume of paper per visit did as well. Health systems used massive filing cabinet systems to organize the information. Needless to say, while the information was there, it was extremely inaccessible. 

The power of policy

By the 1990s, the need to move away from paper-based health information and into electronically-stored health information became increasingly apparent and, ultimately, mandated by the government: from the establishment of a Workgroup for Electronic Data Interchange (WEDI) by President H.W. Bush in 1991 to the signing of HIPAA by President Clinton in 1996, which included a key provision that mandated the adoption of EDI standards enacted by Bush. Portions of healthcare information began to slowly transition out of large filing cabinets and into computers. 

Even with these advancements, in the early 2000s almost every hospital stored some amount of paper records in huge, movable filing cabinets. This dynamic began to change when President Obama signed the HITECH Act in 2009 as part of the recession recovery package. It established meaningful use guidelines for EHRs, massive incentive payments to implement EHRs, and penalties for not complying. 

Those early 1970s systems only equipped to handle billing and scheduling had evolved to handle almost every administrative task for the health system - from appointment scheduling to patient history documentation to ordering prescriptions. There was even capability to build workqueues in the EHR system to make prioritization easier than ever and to implement guardrails to ensure no appointment was left unscheduled and no claim left unpaid.

So why didn’t EHRs solve all our health information problems?

Between 2009 and 2016, consulting companies stepped in to help health systems make these massive transitions. They would assess the health system’s workflow, figure out where manual processes needed to be automated, and help the system build out their EHRs accordingly.

Given that most health systems now have an EHR of some type in place, the focus has shifted from implementing EHRs to optimizing efficiency and ROI of EHRs. Health systems may need to consolidate several different EHRs or optimize the workflow of an EHR or create better claim denials reporting and consulting companies will step in to help solve these issues. However, EHRs work across many components of the health system and one off solutions don’t solve the underlying frustrations healthcare workers have with EHRs.

So what’s next?

This is where Artificial Intelligence (AI) plays a crucial role in the next frontier of the EHR and HIM. Robotic Process Automation (RPA) is becoming increasingly prevalent to automate repetitive, high-volume tasks and free up time for the workforce to focus on more high-value tasks. While AI is often viewed as a tool to replace the workforce, the reality is that 75% of human tasks require cognitive reasoning. 

So while some AI tools help free up time, others, like cybernetics, can help healthcare workers do their jobs more effectively. Instead of sifting through a massive EHR, Rotera’s cybernetics loops can surface information instantly, and precisely when needed, based on the activity being performed or the request being made by the end user. 

And the applicability is worker agnostic - from providers to billing representatives to call center managers everyone can stand to benefit from cybernetic loops. Rotera can map SNOMED to ICD-10 codes on the fly for clinicians. We can translate lengthy and complicated resource guides into searchable, user-friendly tools to save staff time spent navigating.

We are in an era where technology needs to start working with our workforce, not in place of it. If you’re ready to be on the forefront of healthcare technology and take your workforce to the next level, reach out to us to learn more about how we can help AI work with you.