EHR integration with Box suggests a trend: cloud services for care coordination and one-stop patient record access.
Patient portals attached to EHRs are spreading rapidly, mainly a result of Meaningful Use Stage 2 requirement that providers share records electronically with patients. In response to a brand new Frost & Sullivan report, 50 percent of hospitals and 40 percent of ambulatory physician practices have already got such portals. But it’s unclear whether the sort of patient portal has the functionality required ultimately for patient engagement and collaboration among unrelated providers.
One recent development shows the potential for an alternate path. The cloud-based file-sharing vendor Box announced that a link to its service was embedded within the cloud EHRs of Dr. Chrono and CareCloud. Physicians using these EHR systems can easily transfer patient records to Box, where patients can securely download them or transfer them to other providers.
Theoretically, if Box or another cloud service provider persuaded enough EHR vendors to join up, patients with multiple providers could download and aggregate all their records in a single place. Instead, they need to now access their records on multiple portals attached to the EHRs of other practices and hospitals. In response to a up to date KLAS report, just 14 percent of EHR-tethered portals included information from health information exchanges (HIEs), and 11 percent included data from other EHRs.
Albert Santalo, president and CEO of CareCloud, told us that it decided to embed Box as it is ubiquitous and simple to exploit. “While CareCloud also has the facility to share records through our own portal, we feel that Box is a more standard platform.” Also, patients wish to download records from multiple providers. “Sometimes they need to head beyond a patient portal, so Box facilitates that.”
Santalo believes that patients needs to be capable of access all in their records in a single place. “Patients must be accountable for their records, it’ll be easy to get to, and it may be a byproduct of what the doctor does. The patient do not need to do lots of work to populate their personal health records. That’s why other initiatives have failed, like Google Health and Microsoft HealthVault. They put an excessive amount of burden at the patient.”
Microsoft, which still operates HealthVault, has long tried to get providers to send patient records to HealthVault, which will be stored in patient-controlled personal health records (PHRs). Its website says “a growing list of labs, pharmacies, hospitals, and clinics” will send patient records to HealthVault upon request, but it surely hasn’t made any big announcements about this in years.
The Meaningful Use regulations allow providers to send records to PHRs to fulfill the record-sharing requirement. So Microsoft has applied for certification of HealthVault as EHR technology that may be used to teach Meaningful Use in Stage 2. Missy Krasner, managing director of health and life sciences for Box, said it is considering whether to hunt Meaningful Use certification.
However, Femi Ladega, global industry technologist for healthcare and life sciences on the consulting and research firm CSC, told us the power to assist providers achieve Meaningful Use is secondary to any other advantages of a cloud-based patient portal. The care delivery model is shifting toward “a shared accountability with the patient,” and this requires the potential to create two-way online communications between patients and all their providers.
To do this, he said, providers must create an infrastructure that goes beyond the EHR of a person practice or hospital. “A health information exchange could be a part of that infrastructure, and its dataset could be portion of that ecosystem. But you intend to pull data together from multiple sources.”
A cloud-based portal should be had to function a central point for patients to aggregate their medical records and forward them to their providers. However, this sort of portal needs to be in a position to “provide the appropriate infrastructure for the associated data governance while assuring the knowledge should be depended on and trusted.” The portal also must show where every bit of data came from and enable providers to know the context of the info “to drive the correct interventions.”
This type of cloud-based portal can co-exist with EHR-related portals, Ladega said, nonetheless it should be in a position to give patients the whole information they should manage their very own conditions, including educational materials, care alerts, and other self-management tools. And it must provide the potential for bilateral communications between patients and providers across care settings.
“That’s why you would like an ecosystem that permits effective data sharing, underpinned by this infrastructure that will trust the info that’s being shared and lets you act effectively on it,” he said.
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