The future of the electronic health record (EHR) beholds many great advances in the collection and dissemination of valuable health care data when and where it is needed. With these great advances will come great challenges and barriers to overcome. Recent advances in EHR technology and Health Care Information Systems (HCIS) in general, allow interoperability with various remote devices. These remote devices can be used for home or telemonitoring like glucose meters and Holter monitors, self logging of Arthritis signs, etc. In the future we are going to see the industry literally deluged with self monitoring apps and wearables monitoring and logging things yet to even be conceived. These devices will monitoring everything 24/7 from heart rate, breathing, physical activity, sleep and the list just goes on and on and keeps growing and innovating.
This influx of data from a multitude of connected devices will be a challenge to incorporate into EHR platforms. The data is important and exceptionally valuable and should not be discarded due to excessive the size of the data, or even it’s lack of current use cases. It is important, for instance, data about a patient’s sleep states and patterns be preserved for when it is needed even though the present state of the patient may not warrant it.
Another challenge with this new influx of data is interoperability. Being able to obtain, store, utilize and analyze the data from these myriad sources within and across the EHR should be considered a basic function of the EHR and supporting systems. Standards are already in place to expedite integration and data interoperability, however as can see in the research of Giannangelo and Fenton, standard terminologies like SNOMED-CT and LOINC are having difficulty gaining tracking. Furthermore, I have seen from my own experience the immense difficulty involved with getting a laboratory information management system to talk with EHR systems. Standards like Health Level 7 assist in the process but integration still remains a huge obstacle.
The health care industry’s future is ripe for the development of, and EHR integration with, mobile health monitoring apps, devices and wearables. All of which collect droves of data concerning all aspects of a person's health from vital signs to nutrition to sleep patterns. It will be interesting to see this industry evolve, grow and overcome these continuing challenges and pitfalls of interoperability and data integration.
Gartee, R. (2017). Electronic health records: understanding and using computerized medical records. NY, NY: Pearson.
Giannangelo, K., Fenton, S.H. (2008). SNOMED CT Survey: An Assessment of Implementation in EMR/EHR Applications. Perspectives in Health Information Management. Spring 2008.
Robert J. Fawcett September 21, 2017