A patient centered electronic health record (EHR) system is one designed with the ultimate goal of improving patient care. The primary design of a patient centered EHR is focused around functionality that promotes improved patient outcomes, enhanced patient experience and increased patient engagement.
So how can you tell if an EHR is patient centered? The following are qualities of a patient centered EHR:
- Single database practice management and EHR technology. More and more, the demands being placed on the provider require careful thought be given to system integration for ambulatory automation. Now more than ever, practitioners should strive for a clinically-driven financial system, one that is a true single-database for all three components of practice automation: financial, operational and clinical. In so doing, the practice is afforded a comprehensive patient registry for patient centered operations.
- Strong clinical decision support tools. The EHR should include pre-designed clinical guidelines, diagnostic support, order sets, reference information and more. This allows practice to manage patients beyond when they come to the office for adherence to evidence-based prevention, wellness and disease management protocols.
- Clinical protocol compliance tracking. The EHR should be an inherent patient registry by design, enabling performance of simple patient population queries based on diagnosis and procedure codes as well as more detailed queries based on order results, medications and anticipatory guidance parameters. The EHR should also proactively alert providers at the point-of-care if patients are not complying with the guidelines and protocols.
- Robust patient relationship management. The EHR should include patient communication tools, such as the ability to send appointment reminders via email or text, queue up phone lists or mail-merge outreach letters depending on the patient's contact preference.
- Inherent patient portal. Your EHR vendor should provide a patient portal that is inherent to the EHR and is easy for patients to navigate. As the hub of patient centered communication, the patient portal should be core to the base offering, not a add-on solution that requires third party licensing and integration to the EHR.
- Advanced e-prescribing functionality. A patient centered EHR goes beyond simple e-prescribing capabilities and also includes prescription order history that shows what prescriptions were actually filled, not just ordered. eRx management should include the ability to see medications filled that were written by an outside provider with the ability to add these drugs to the current medications list in a reconciliation workflow. eRx should also promote the ability to share drug formulary information to assist the patient with the cost of and adherence to pharmaceutical therapies.
- Strong medication management tools. The EHR should help clinicians select safe, effective and appropriate medications by providing patient and condition-specific dosing recommendations. The system should conduct automatic checks that prevent contraindications, therapeutic duplications, drug-drug interactions, drug-lab interactions, drug-disease interactions and clinically significant allergies. The EHR should also help ensure that the medication is prescribed for the correct dose, route and frequency.
- Strong health information exchange (HIE) capabilities. A patient centered EHR should, at a minimum, have the ability to generate a continuity of care document (CCD). Ideally, your EHR should have real-life HIE experience and be working with multiple HIEs in production. This allows the provider to have a longitudinal view of the patient's health record for care that places the patient in the centered and is holistic.
- Patient education. The system should include patient-specific education that is available in a variety of languages, is customizable and includes graphics to assist with understanding. The system should queue appropriate educational handouts automatically as a by-product of encounter documentation for relevant wellness and disease management guidance.
- Order tracking and the ability to receive lab/imaging results. This helps providers take better care of patients by eliminating lost results and making it easy to track deferred orders, delinquent orders and orders not performed. This feature also makes it easy to trend lab results to compare values over time, and use lab results to trigger clinical decision support alerts.
- Strong clinical quality reporting capabilities. Clinical quality reporting initiatives, such as the Physician Quality Reporting System (PQRS), are aimed at improving patient care by rewarding physicians for quality and making quality information available to the public. For the strongest quality reporting capabilities possible, look for an EHR that is qualified for PQRS EHR Direct reporting.
- Structured knowledge base. This sounds like a given for any EHR, but surprisingly, it isn't. Some EHRs that are advertised as low cost and easy to use lack this critical functionality. While a narrative component to the encounter note is important, the EHR should include a fast, easy-to-use approach for templating structured data that is associated by clinical relevance to other terms and also maps to standards-based clinical vocabularies such as SNOMED, LOINC and RxNORM. In so doing, the provider is positioned for data interoperability, reporting and research – all foundational to patient centered care.
To learn more about selecting a patient centered EHR, check out 10 tips for EHR assessment.