Today’s Electronic Health Records (EHRs) can’t be compared to earlier
systems of their namesake that surfaced in the 1960s. Early EHR
systems were developed to replicate a paper medical chart and store
clinical notes, making EHRs some of the first health-related programs
written for modern mainframe computers. As the years rolled on, the
demands of clinical care, not to mention the advancement of health
information technology, eventually expanded and encompassed what was
possible through such programs. Consequently, EHRs quickly increased
in complexity to encompass additional features such as clinical
decision support, electronic prescribing, and data analytics.
Off-the-shelf solutions quickly became the norm in hospital and clinic
settings, defining a one-size-fits-all approach to medical care to
automate and accelerate work while improving patient outcomes.
This
means that EHRs have become a critical tool in modern healthcare. They
help health centers manage their data, track medical histories, lab
results, treatments, and diagnoses, transfer, and transport historical
information from different healthcare providers, coordinate providers'
care, and manage patient data in a way that improves the integrity of
the data and enhances regulatory compliance (e.g., HIPAA and GDPR).
However,
despite all the advantages of off-the-shelf EHR systems, we see that
these generic solutions can’t solve the challenges and needs of each
healthcare organization. As the industry becomes more and more
niche-based, more of its providers feel that these generic EHR
solutions fail to match their operational requirements. All this has
culminated in a growing shift towards custom-coded EHRs that can be
tweaked per the institution’s specific workflow processes and create
better interoperability, care paths, and tailored provider and patient
experiences. The huge advantage of custom EHRs is that they offer
higher flexibility and ease of scaling, making them more future-proof
given the ever-changing healthcare landscape.
Built for rote functionality, off-the-shelf EHR systems are rarely customized to specific workflows, often unique to a particular care practice. As a result, off-the-shelf systems often prove inadequate for clinicians in any niche care setting. Organizations employ numerous workarounds to make these systems work, almost always creating delays, inefficiencies, and extra investment. The problem is that since off-the-shelf systems cannot be easily customized, they disrupt the clinical workflows rather than complement them. This is a major reason why staff end up frustrated with the system, which slows the ability to care for patients.
As healthcare organizations expand or transition, the business needs of the practice change. While off-the-shelf EHRs are intended to be ‘one-size-fits-all,’ they were generally designed for a clinical environment with standardized orient readily to larger volumes, add new specialties, or expand service offerings. When the underlying EHR cannot scale, healthcare providers are forced to move forward with a costly system overhaul or continue using outdated software that has an increasingly difficult time keeping up with the practice's growth, driving down efficiency and performance.
Off-the-shelf solutions can also create data silos – they often don’t integrate well with other healthcare systems, making it more difficult to share information between systems in a way that creates continuing patient records and enables care coordination. Without the capability for plug-and-play interoperability with lab systems, billing software, and other needed platforms, off-the-shelf EHRs can hinder care more than aid.
Most off-the-shelf EHR systems have usability issues. Most are built without much consideration for the day-to-day lived experience of clinicians. Providers’ workdays can be slowed by convoluted interfaces, inefficient workflows, and high amounts of documentation, creating a frustrating experience that adds to burnout. These issues don’t just impact clinicians’ jobs. They directly affect patients. When clinicians spend more time looking at and entering data into the EHR than at their patients, the quality of care can suffer, leading to both lower patient satisfaction and increased risk of medical errors.
The increasing need for specialty-specific EHRs stems from the fact that different parts of our healthcare delivery system are becoming more complex, which in turn is resulting in a higher demand for more specialized solutions. Prepared using the best knowledge available at the time, current off-the-shelf EHR software does not do an effective job of meeting the specific needs of small private practices with four employees and four exam rooms compared with large hospital networks with thousands of beds, hundreds of doctors, and thousands of employees. Out-of-the-box EHR suppliers cannot meet everyone’s needs.
While generic solutions require organizations to adjust their workflows to fit the EHR, custom EHR design enables organizations to design the EHR around their workflows. Custom EHRs are more flexible, easier to use, and more likely to scale with the organization. Custom EHR design enables clinicians to minimize workflow adjustments to accommodate system limits. They can pay fewer ‘mental taxes’ precisely because the system has incorporated their workflows into its rules and procedures. Custom EHRs are also more effective at accommodating changes in an organization’s structure or personnel. Organizational circumstances change, leading to functional and workplace adjustments. A system that allows organizations to add or change the automation of functions will be more effective at accounting for personnel changes, changing spaces, and alternative workflows than a system that maintains a single workflow. It will also be more effective at scaling into more types of organizations.
Another key advantage of custom EHR solutions is that they can be optimized for integration with other mainstay care systems such as telemedical systems, records from lab facilities, billing systems, etc. By ensuring that custom EHRs can work in harmony, independent systems can be connected so that data can be flowed in from multiple sources, which makes the coordination between departments smoother. It improves decision-making and derived analytics, which helps improve workflow and patient care outcomes. A custom EHR, for example, can connect all the different information from the other source systems into a single database that is easily manageable.
This is perhaps the most appealing and definitive advantage of custom EHRs: they can be built to align perfectly with the specific workflows of healthcare providers. Conversely, off-the-shelf digital record-keeping systems commonly involve a ‘one-size-fits-all’ process. Custom EHR development bridges this deficiency because they can be integrated to follow the same processes as the landscape they were built for – from the care of patients to the ordering of tests to billing and payments. This results in a streamlining of routine tasks and automation of manual work, which manifests in fewer clicks and a reduced administrative burden.
Custom EHR solutions offer a better way of managing clinical data. Custom EHR systems address the shortcomings of generic EMRs. Unlike one-size-fits-all EMR systems that do not always suit a specific practice, custom EHRs are developed for the organization's needs: improving data accessibility, providing easy ways to store and retrieve information intuitively, improving a workflow, or streamlining billing and other operational processes. Custom EHR solutions allow readily available information, keeping critical patient information on file and accessible when needed. This is crucial – a clinician must locate a patient history with a sense of urgency and security, knowing that receiving comprehensive information from the past will help guide the patient’s current care and decision-making. Readily accessible information contributes to a more efficient workflow, better outcomes, and patient satisfaction.
Another advantage of custom EHR solutions is greater interoperability with existing healthcare technologies. Custom EHRs can be built to communicate with other systems already in the healthcare environment, like laboratory information systems, billing platforms, telemedicine-type solutions to support sessions over a distance, etc. They can also be built to be flexible enough to handle future technological advancements that will inevitably come.
Custom EHR solutions have more robust security and compliance based on regulations such as HIPAA. They would enable dedicated security measures, such as enhanced encryption and access controls, that are more precise than those available to vendors of generic EHRs. This would help ensure that patients’ sensitive information is kept private, protected from unauthorized access and potential breaches, and prevent regulatory penalties. It would also help ensure the integrity of the healthcare system and keep patients’ trust in the integrity of the facility.
Personalization is a hallmark of custom EHRs, resulting in customized experiences for clinicians and patients. Custom EHRs adapt the system to the specific users of that system, which makes it easier for clinicians to navigate the software, allowing them to work more efficiently and experience less frustration. For patients, incorporating personalization into an EHR solution can make communication and engagement tools feel more customized and welcoming, bolstering their experience and perception of the care they’re receiving.
The role of custom EHR development in the future will be greatly impacted by innovations in artificial intelligence (AI), machine learning, and predictive analytics. AI will imbibe EHR systems with multifaceted data analytic functionalities and next-gen clinical decision support, among other advancements. Machine learning will also come in handy for easing the automation of certain clinical tests, diagnostic imagery, and analysis, drastically reducing human error in these sensitive areas. Predictive analytics can generate actionable insights from prior patient data to gauge the likelihood of health complications and suggest prevention strategies. These innovations will assist in streamlining data management and facilitate better decision-making, improving patient outcomes.
The flexibility of data management and the mobility options that come with cloud-based EHR solutions increasingly favor healthcare organizations. There are significant advantages to be gained from leaving on-premise systems in an era of storage scalability, the ability to easily access patient data from any location, and the opportunity to have EHR systems that can update themselves without the expense of extensive IT infrastructure. Broadly, cloud adoption is increasing across all sectors as companies become more agile and flexible in remote work. There is a need for more cost-effective solutions that boost collaboration and efficiency, and there is an ongoing desire to leverage data for business growth to its utmost value.
With the growing industry and changes year to year, one thing that will be of supreme importance alongside the future course of healthcare delivery is the requirements of an EHR – custom EHR solutions. EHR solutions have to be lined up adaptably for future advancement in healthcare practices, care models, and regulatory frameworks so that EMR systems can expand and scale with the growth of the healthcare system. Scalable custom EHRs, like EMRs, can fit into a healthcare organization by extending its capacity to withstand changes and demands and incorporate new functionalities for the future. This will also aid in scaling while overseeing new services, specializations, and technologies emerging in healthcare delivery.
Over time, off-the-shelf EHRs have transformed into custom EHRs. While they provided a major leap in healthcare delivery, for many healthcare systems, the ultimate benchmark requires more tailored solutions. Custom EHR provides such capabilities and improves workflow in healthcare settings by ensuring flexibility, scalability, and better integration with existing systems, leading to better patient care. The healthcare sector will continue to see more tailored solutions where systems undergo dovetailing to make them deployable and sustainable in compliance with changing trends and developments. This will ensure that the systems remain adaptable, more secure, and capable of fulfilling the evolving needs of the complex healthcare environment.
