SmartEHR: Advancing Personalized Medicine through Revolutionary EHR IT Technology
--
This article is published as part of Hamid Torabzadeh’s project focused in Personalized Medicine. An introduction to the research concept can be found here, a video technical review of a specific intervention can be found here, an in-depth article focused on the project can be found here, and a literature review highlighting EHR innovation can be found here.
Background
In the recent decade, electronic health record (EHR) systems have become increasingly more popular and widespread across healthcare systems in the U.S. and developed society.
EHRs have the potential to transform the healthcare system from a mostly paper-based industry to one that utilizes clinical, operational, and environmental information to assist care providers in delivering higher quality of care to their patients while cutting down on financial waste.
The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, which is part of the American Recovery and Reinvestment Act (ARRA), was signed into law with the primary objective of incentivizing providers (i.e. hospitals and physicians) to adopt EHR systems.
Given their increased development and adoption, EHRs offer numerous benefits and improved outcomes including:
- Clinical Outcomes: improvements in the quality of care, reduction in medical errors, and other improvements in patient-level measures.
- Organizational Outcomes: improved financial and operational performance and satisfaction among patients and clinicians who use EHRs.
- Societal/Population Health Outcomes: efficient operational methods of clinical research and improved population health.
However, despite these many advantages, EHRs face numerous challenges for both providers and patients, while failing to deliver on key areas of promise involving big data in healthcare.
P.S. → To learn more about EHRs and general potential improvements, check out my previous article: How to Optimize EHRs to Advance Personalized Medicine — A Literature Review
The Personalized Medicine Problem
Although there are various, diverse challenges facing EHRs, I will be focusing primarily on the shortcomings of EHRs as related to leveraging key sources of data and delivering personalized outcomes.
With that being said, key shortcomings in these areas include:
1 — Underutilized Data
Traditional EHR data input infrastructures and systems are not going to be sufficient for delivering next generation healthcare. Historically, EHRs have been largely record-based, and not system-based. We need to start creating a culture which values the EHR as a mechanism for improving care, rather than just recording existing health metrics.
EHRs have enormous potential to integrate various data sources beyond the direct primary care record, including mobile computing and mobile health (mHealth) and Internet of Things (IoT) — to mention a couple.
2 — Lack of Interoperability
The failure to expand interoperability of healthcare data has negatively impacted efforts to modernize the American healthcare system. One of the primary barriers to interoperability rests in the fact that the hundreds of proprietary EHR systems or medical devices on the market do not easily share data.
Interoperability-related problems extend profound barriers for providers and patients alike when information cannot be shared across settings. Healthcare organizations are looking for EHR solutions that can provide the most comprehensive, accessible insight into each patient quickly.
This underlying inability to effectively transmit information across institutions hinders a holistic approach to an individual’s health.
3 — Lack of Patient Engagement and Input
Finally, one of the most prevalent shortcomings of current EHR systems is a lack of inherent coordination with patients. EHRs are serving as a one-way input of data — leaving many patients concerned about their privacy while failing to provide them a meaningful opportunity to contribute to their own care.
An increasing amount of evidence has begun to demonstrate that patients who are more actively involved in their health care experience better health outcomes and produce lower costs. As a result, many health care organizations are implementing various strategies to better engage, educate, and empower patients to have more control over their own health.
One of the results of increased patient engagement techniques includes increased potential for data input on the part of patients. Although patients are becoming more and more engaged with technologies including mobile apps and wearable devices, EHR systems are not designed to integrate these valuable data parameters.
To provide an example, analysis of data collected from chips or sensors through IoT infrastructures may reveal critical information that might be beneficial in improving lifestyle and preventing disease.
IoT devices create a continuous stream of data while monitoring the health of individuals which makes these devices a major contributor to big data in healthcare. Despite the potential, EHR systems are not allowing two-way input that opens portals and platforms to patients.
The Solution — SmartEHR
Mission:
To advance personalized medicine by employing revolutionary, innovative information technology (IT) solutions — particularly in the area of EHRs.
Technical Overview:
SmartEHR employs a cloud-based EHR solution available on both mobile and web platforms. The software is designed for all involved health ecosystem stakeholders — including both providers and patients — with an underlying goal of delivering a holistic record of each patient.
The software will be targeted towards a diverse set of health professionals — with selective access to specific features — in hopes of ensuring broad coverage of patients’ health information. This includes primary care providers, hospital administrative staff, nurses, laboratory professionals, physical therapists, suppliers, and pharmaceutical companies.
In doing so, all Health Insurance Portability and Accountability Act (HIPAA) rules and regulations will be closely complied with in order to ensure patient confidentiality, safety, and privacy.
Key Features:
SmartEHR employs a comprehensive, fully integrated platform with all needed features to ensure cutting-edge healthcare delivery and operations.
Features currently available in well-known EHR systems will be included:
- Patient Demographics
- Patient Scheduling
- Electronic Medical Records
- Prescriptions
- Medical Billing
- Clinical Decision Rules
- Patient Portal
- Reports
In addition to these mentioned above, the heart of SmartEHR’s solution relies on various new, cutting-edge features to improve delivery methods and to solve the aforementioned shortcomings. These include:
1 — Smart Personalized Medicine Dashboard
This dashboard builds on the idea of Clinical Rules or clinical decision support systems (CDS) which can leverage the existing data sitting in an EHR. Oftentimes, the biggest challenge in promoting sensible interventions for patients is not a lack of data, but rather a lack of utilization of the data.
This dashboard will leverage various data analysis frameworks and algorithms that incorporate artificial intelligence, supervised and unsupervised learning, and basic prediction and prevention modeling and visualization.
The goal of the dashboard is to equip providers with the opportunity to track specific parameters of health of a given patient. Some of these may include:
- Social Determinants of Health (SDOH)
- Lab and Test Results
- Chronic Disease Prevention
- Vaccination Records
With algorithms proactively monitoring all this data using specialized, personalized, and clinically-backed methods, care providers have the power to save time, be more efficient, and improve overall outcomes.
2 — External Monitoring Dashboard
The future of EHRs also requires integration of external user inputs — transforming the medical record from merely a documentation tool to a robust, personalized healthcare delivery system.
The external monitoring dashboard would sync with external devices and wearables in order to provide these records with holistic coverage of each individual patient.
In order to form these integrations, SmartEHR would provide health care providers with exclusive access to a proprietary mobile app which can be distributed to all patients who opt in through their health providers.
SmartEHR will work with digital health wearable companies in order to employ sync capabilities with devices such as:
- Wearable Fitness Trackers
- Smart Health Watches
- Wearable ECG Monitors
- Wearable Blood Pressure Monitors
- Biosensors
As widely looked into, US consumer use of wearables increased from 9% to 33% in just four years, and this number will continue to grow as wearable technology becomes more conventional.
3 — HIPAA Compliance
HIPAA stands for Health Insurance Portability and Accountability Act, which was introduced in the year 1996. Although HIPAA is a regulation designed for the USA, their equivalent regulations have been promulgated across many countries.
HIPAA legislation was designed in order to regulate and increase the efficiency of digital health apps and software for the healthcare industry. HIPAA also has provisions to ensure the privacy of patient information and data security.
SmartEHR will employ industry-available secure information exchange (IE) methods available on the market in order to expand distribution of electronic information of patients in various media across various healthcare stakeholders including patients.
Works Cited
- Benefits and drawbacks of electronic health record systems
- Disadvantages of EHR systems — dispelling your fears
- Pros and Cons of Electronic Health Records
- Big data in healthcare: management, analysis and future prospects
- Patient Engagement
- Health IT Data Summaries
- Creating a HIPAA-Compliant mHealth App: 6 Vital Facts You Should Know
About the Author
Hamid is a student based in Long Beach, CA. His interests lie in medicine, healthcare, biomedical engineering, and business. He strives to make a meaningful impact in the areas of clinical practice, healthcare delivery, and public health by leveraging technology and innovation.
If you’d like to connect, you can find him on LinkedIn, Medium (you’re already here!), and Twitter, or you can email him at hamidtorabzadeh@outlook.com.
